基于机制设计理论的复杂型医疗服务项目定价模型研究

Research on the Pricing Model of Complex Medical Service Items Based on Mechanism Design Theory

目的:从机制设计的角度,利用博弈规则构建复杂型医疗服务项目定价模型,探索多方参与的价格形成新机制,为理顺医疗服务价格提供参考。方法:首先采用不完全信息静态博弈,分别在两家及n(n>2)家公立医院参与下,构建报价理论模型;其次利用概率论与数理统计对模型进行求解与分析。结果:博弈结果贴合实际,机制设计较为合理,两家及n家公立医院报价模型均存在大于或等于真实成本的贝叶斯线性均衡解,该均衡报价随成本增加而增加,并随报价医院数量的增加而逐渐接近于真实成本。此外,均衡报价下确定的项目定价不一定能够弥补所有公立医院的成本,但可以确保其亏损最小化。结论:本研究构建的理论模型能够形成公立医院与政府价格规制部门的参与约束和激励相容约束,实现预期定价目标,可为新时期医疗服务项目定价提供新思路。

Objective:From the perspective of mechanism design,game rules are applied to construct a pricing model for complex medical service items,explore a new mechanism for multi-party participation in price formation,and provide references for rationalizing the price of medical services.Methods:Firstly,using incomplete information static game,with the participation of two and several public hospitals,respectively,construct the quotation theory model;secondly,using probability theory and mathematical statistics to solve and analyze the model.Results:The result of the game fits the actual situation,and the mechanism design is more reasonable.The quotation models of two and several public hospitals all have a Bayesian linear equilibrium solution that is greater than or equal to the true cost.The equilibrium quotation increases with the increase in cost and the quotation of the hospital.The increase in quantity gradually approaches the true cost.In addition,the project pricing determined under the balanced quotation may not be able to cover the costs of all public hospitals,but it can ensure that its losses are minimized.Conclusion:The theoretical model constructed in this study can realize the participation constraints and incentive compatibility constraints of public hospitals and government price regulation departments,achieve the expected pricing goals,and open up new ideas for the pricing of medical services in the new era.