社区医养结合服务参与主体行动逻辑及调适策略

The Action Logic and Adjustment Strategy of the Participants in the Community Medical and Nursing Service

人口老龄化背景下老人对社区医疗服务和养老服务需求叠加,但供需侧存在利益不均衡,导致社区医养结合服务有效供给存在不足。为了纾解因老龄化所带来的养老压力,本文基于利益相关者理论,在构建地方政府—社区医养结合服务机构—社区老年群体三方静态博弈基础上,引入动态监管博弈结构模型,厘清三者的利益和行为之间的关系,并运用李雅普诺夫判别法分析演化博弈模型均衡点的渐近稳定性。研究表明,引入动态监管能够较好地抑制利益主体的行为策略波动,使得社区医养结合服务机构合规经营成为最优选择。同时,地方政府在财政上给予社区医养结合服务机构和社区老年群体适当补贴,能够保证利益在各主体之间公平合理分配。

Under the background of an aging population,the elderly have overlapping demands for community medical services and old-age care services,but there is an imbalance of interests on the supply-demand side,resulting in insufficient effective supply of community medical and old-age care services.In order to relieve the pressure of pension for aging,based on stakeholder theory,in the construction of local government-community-a combined with institutions based on static game,the three of the elderly into the structure of dynamic supervision game model,clarify the relationship between the three interests and behavior,and evolutionary game model is analyzed using lyapunov criterion asymptotic stability of the equilibrium.The research shows that the introduction of dynamic supervision can better restrain the behavioral strategy fluctuation of stakeholders and make the compliance operation of community medical and nursing institutions the optimal choice.At the same time,local governments provide appropriate financial subsidies to community medical and nursing institutions and community elderly groups,so as to ensure fair and reasonable distribution of benefits among various subjects.