基于利益相关者理论和博弈论的公立医院利益补偿分析

Analysis of Public Hospital Reimbursement Based on Stakeholder Theory and Game Theory

应用利益相关者理论和博弈论对现实条件下公立医院利益补偿进行分析,认为公立医院利益补偿制度安排必须满足"激励相容"原则,使得政府、医院与患者的目标函数趋于一致,才能使医院、患者等利益相关者彼此的效用都最大化,从而缓解利益相关者的矛盾冲突。鉴于KP医疗集团有效的运作模式,建议在我国部分地区建立由政府主导,整合预防保健、社区医疗、住院服务及保险功能于一体的非营利性医疗集团,来解决医患利益一致性问题,达成降低医疗成本、提高医疗质量的社会目标,为医药卫生改革提供思考路径。

In the paper, stakehohter theory and game theory are employed to analyze reimbursement of public hospitals. The result is that reimbursement system of public hospital must meet principle of the incentive compatibility, ensuring the objective function of government and hospitals to get maximization utility of hospitals, patients and other stakeholders to alleviate the conflict. In view of Kaiser Permanente＇s business model, it is proposed to establish a non-profit medical groups integrated prevention, care and community health care, hospital and medical insurance to coherency system profit, for assuring quality of health care and lowering medical expenses.