两级医疗服务链系统仿真与政策分析

System Dynamic Modeling and Simulation on a Healthcare Services Chain

当前我国医疗机构间的分工协作体系仍然没有形成,医疗资源紧张和闲置并存。通过应用系统动力学对两级医疗服务链系统进行建模与仿真研究。重点研究了综合医院医疗负荷的波动和医疗服务能力的增长问题。研究结果表明由于系统中存在延迟和反馈,医疗需求的波动会显著影响系统的绩效水平,而政府对基层医院实施财政补贴政策在一定程度上加剧了综合医院的医疗负荷波动问题,而通过两级医院的协作能够减缓波动,提高系统的整体绩效,论文最后提出了政策建议。

China has started to deepen the health care system reform to establish the system of graded diagnoses and treatment.This paper develops a behavioral dynamic model of the healthcare services chain with endogenous capacity adjustment and other feedbacks to explore the service fluctuation and capacity expansion.The result shows the bullwhip effect in healthcare service chain reduce the system performance and the government policy of financial support for primary hospital is not a very influential determinant,instead the collaboration between the hospital may have the significantly effect to improve health system performance.