ABSTRACT
The hierarchical diagnosis and treatment system is an important measure for rational allocation of medical resources, promotion of equalization of basic medical services, improving the patients' disorderly medical treatment and guiding patients' hospital choice behavior. This paper defines the utility function of rational medical treatment of patients affected by multiple factors such as the personal disposable income,the age,the severity of the self-induced illness and the decision-makers' education level, and considered the outpatient price, service capacity and other factors of medical institutions. The present study constructed the incomplete information dynamic game model based on fictitious play method. It provided the quantitative analysis of the statistical data of Qinhuangdao and obtained the patients distribution in medical institution. The rationality of the model was verified by comparing the simulation with actual data,and showed the choice is more reasonable between the primary health care and general hospital. Therefore,the emphasis of optimizing the medical service resources in hierarchical diagnosis and treatment system is to establish the treatment system of integrated medical service for patients'on-demand and on-demand medi-cal services. At the same,various incentives should be used to enhance patients'enthusiasm for primary health care.
ABSTRACT
The paper analyzed the decision-making process of the doctor's treatment and patient's decision-making. Then established the evolutionary game model of patient's and the secondary-tertiary hospital doctor's strate-gy. The Matlab simulation software were used to analyze the influencing factors of patient-doctor strategy-making sys-tem. We proposed the advice reducing critical patient's utility loss diagnosed in secondary hospital,improving medi-cal experience of common patient in secondary hospital,strengthening disease prevention of critical patient,and pro-moting labor division and cooperation between secondary and tertiary hospital to make result develop towards reduction the disorderly,chaotic and dislocated medical need and an integrated secondary and tertiary system.
ABSTRACT
The paper analyzed the dilemma of rural family physician signing model. Then established the evolutionary game model of residents' and the rural family physician's strategy. The Matlab simulation software were used to analyze the influencing factors of residents and family physician strategy-making system. We proposed the advice enhancing the enthusiasm of signing the family physician, increasing the proportion of residents signing the personalized service package, reduction of utility loss caused by family physician's "lazy" strategy, the cost reduction of basic medical service provided by family physician, improving the award of effective signing and the punishment mechanism of not ideal health management to make result develop towards the residents' signing the family physician and an integrated basic medical service system.
ABSTRACT
OBJECTIVE: To explore the relationship among mental health,negative perfectionism and coping style of firefighters. METHODS: By stratified random sampling,404 firefighters at work were selected and investigated by SelfReporting Inventory( SCL-90),Negative Perfectionism Questionnaire( ZNPQ) and Simplified Coping Style Questionnaire( SCSQ). The relationship between control variables and results variables was analyzed by using correlation analysis and structural equation model. RESULTS: The SCL-90 total scores of firefighters were positively correlated with ZNPQ hesitate and fear of failure factors( P < 0. 05); was negatively correlated with SCSQ positive coping factor( P < 0. 05),and was positively correlated with negative coping factor( P < 0. 05). The higher score of the hesitation and fear of failure factors,the higher total score of SCL-90( path coefficient were 0. 28 and 0. 35). Hesitation had a positive predictive function to the negative coping styles( path coefficient was 0. 57). The higher score of the negative coping styles,the higher total score of SCL-90( path coefficient was 0. 54),and the negative coping styles have a mediation effect on the relationship between the fear of failure and firefighters ' mental health( path coefficient was > 0. 28). CONCLUSION: Negative perfectionism personality has negative effects in mental health. Firefighters' negative coping style is the part of the intermediary role between the hesitation subscale and mental health,by reducing negative coping style to suppress the symptoms of mental health and to promote mental health.