ABSTRACT
Objective To discuss the dilemma of establishing the hierarchical diagnosis and treatment system in China and the relevant policy recommendations.Method Game theory and Pareto improvement theory can be used to analyze and promote the implementation of the hierarchical diagnosis and treatment system.Results The difficulty of grading diagnosis and treatment lies in the failure to achieve Pareto improvement,that is,patients and the government can save costs in the grading system,but doctors have not been given corresponding incentives,therefore,they are lack of enthusiasm for subsidence.Conclusion The hierarchical diagnosis and treatment system can save the government subsidies for health insurance and medical costs.If the doctor can get part of the costs,they will sink to the grassroots medical institutions,which can realize the Pareto improvement.The order of medical treatment and classification will be formed.
ABSTRACT
This paper analyzed medical dispute litigation from the view of game theory.The adoption of mediation strategy for both hospital and patient was the Pareto optimal of this model.The adoption of court decision for both hospital and patient was the Nash equilibrium and its overall benefit was the Pareto suboptimal of this model.The communication of patient's lawyer can prompt the reconciliation between hospital and patient.On the one hand,it let the hospital realize the responsibilities they should bear,on the other hand let patients be willing to make concessions on the basis of the original claims,and finally made the two sides reach a reconciliation agreement,thus to make conflict between hospital and patient end in litigation and the overall benefits maximize.
ABSTRACT
OBJECTIVE:To investigate the constraint mechanism on excessive medical behavior of doctors in Chinese medical market. METHODS:Under certain assumptions(suppose the hospital and the doctor's demands are consistent,the government and the patient's demands are consistent,etc),mixed game method(game theory)was used to analyze Nash equilibrium between government and doctors,between patients and doctors.The qualitative analysis was performed for these constraints based on the re-ality. RESULTS&CONCLUSIONS:The strict punishing mechanism and the choice right to doctor of patients and public satisfac-tion with the government can achieve the Nash equilibrium of game and effectively inhibit excessive medical behavior. The govern-ment should create a competitive environment to enhance the right of patients to select doctor and improve the relevant legal system on the basis of promoting incentive compatibility among all parties so as to strengthen the implementation of supervision. At the same time,the government should establish credit archives of the doctor to form effective reputation incentive mechanism to doc-tors,and proactively explore the patients participation mechanism based on reducing the cost of patient participation.
ABSTRACT
OBJECTIVE:To investigate the constraint mechanism on excessive medical behavior of doctors in Chinese medical market. METHODS:Under certain assumptions(suppose the hospital and the doctor's demands are consistent,the government and the patient's demands are consistent,etc),mixed game method(game theory)was used to analyze Nash equilibrium between government and doctors,between patients and doctors.The qualitative analysis was performed for these constraints based on the re-ality. RESULTS&CONCLUSIONS:The strict punishing mechanism and the choice right to doctor of patients and public satisfac-tion with the government can achieve the Nash equilibrium of game and effectively inhibit excessive medical behavior. The govern-ment should create a competitive environment to enhance the right of patients to select doctor and improve the relevant legal system on the basis of promoting incentive compatibility among all parties so as to strengthen the implementation of supervision. At the same time,the government should establish credit archives of the doctor to form effective reputation incentive mechanism to doc-tors,and proactively explore the patients participation mechanism based on reducing the cost of patient participation.
ABSTRACT
A escolha de estações de tratamento de esgoto pode, dentre outras coisas, envolver um conflito entre a eficiência e o custo, pois para o menor custo possível esta escolha também deverá satisfazer várias exigências ambientais. Para auxiliar na escolha de uma estação de menor custo, um modelo baseado em técnicas de tomada de decisão foi desenvolvido por Oliveira (2004). Todavia, se não forem levados em consideração os outros critérios envolvidos, a interação entre os tomadores de decisão e suas respectivas estratégias podem fazer com que a escolha do sistema de tratamento não seja a mais adequada. Para estes casos, o equilíbrio de Nash pode oferece uma solução, construída com base na interação entre os jogadores, a qual poderia satisfazer razoavelmente os interesses conflitantes. Desta forma, o objetivo desta pesquisa foi, com base nos dados de saída do modelo de Oliveira (2004), encontrar o equilíbrio de Nash para propor uma solução para o conflito entre a eficiência e o custo nas escolhas do sistema de tratamento de esgoto sanitário. A comparação entre os diferentes resultados alcançados, quando apenas considerado o critério de menor custo ou de maior eficiência, demonstrou que a adoção do equilíbrio de Nash pode ser uma alternativa viável para solucionar o conflito entre a eficiência e o custo nas escolhas das estações de tratamento de esgoto sanitário.
The choice of sewage treatment plants may, among others, involve a conflict between efficiency and cost, because for the lowest possible cost, this choice should meet some environmental requirements. To assist in the choice of a treatment system for municipal sanitary sewer, a model based on techniques of decision making was developed by Oliveira (2004). However, if the other criteria involved are not considered, the interaction between decision makers and their strategies can turn the choice of the treatment system into an inadequate one. For these cases, the Nash equilibrium may offer a solution based on the interaction between players, which could reasonably satisfy the conflicting interests. Thus, the main objective of this research was, based on the data output of Oliveira's model, to find the Nash equilibrium to propose a solution to the conflict between efficiency and cost in the choice of a system for the sewage treatment. The different results found, when taken into account only the criterion of lower cost and the criteria of lowest cost and efficiency, demonstrated that the Nash equilibrium adoption can be a viable alternative to solve the conflict between efficiency and cost in the choice of treatment plants for sewage.