分级诊疗背景下三级医院重症患者康复期转诊的演化博弈分析

An Evolutionary Game Analysis of Rehabilitation Referral of Severe Patients in Tertiary Hospitals under the Background of Hierarchical Diagnosis and Treatment

分级诊疗制度可以缓解医疗资源配置失衡,提高医疗体系服务效率。本文针对我国分级诊疗制度中出现的“下转难”问题,从成本、收益、补贴和心理落差四个视角探究如何推动转诊制度的落实。通过构建上级医院、下级医院与患者的三方演化博弈模型,利用Matlab软件进行仿真分析并提出相应建议。结果表明:减小下转成本、提高政府补贴和减小患者下转后的心理落差,将使各博弈方更倾向于落实下转政策。结论:建立规范、详细的转诊标准,高效的合作模式,调整医疗资源配置等可以提高患者转诊率。

The hierarchical diagnosis and treatment system can alleviate the imbalance of medical resource allocation and improve the service efficiency of the medical system.This paper explores how to promote the implementation of the referral system from four per-spectives:cost,benefit,subsidy,and psychological gap,in response to the problem of“difficult downward transfer”in China’s hierar-chical diagnosis and treatment system.By constructing a tripartite evolutionary game model between higher-level hospitals,lower level hospitals,and patients,a simulation analysis is conducted using Matlab software,and corresponding suggestions are proposed.The re-sults showed that reducing the cost of downward referral,increasing government subsidies,and reducing the psychological gap of pa-tients after downward referral will make all game parties more inclined to implement the downward referral policies.Conclusion:Estab-lishing standardized and detailed referral standards,efficient cooperation models,and adjusting the allocation of medical resources can improve the patient referral rates.