| 基于医生行为的远程会诊申请方参与激励机制设计 |
| Incentive mechanism design for teleconsultation application hospital based on the behavior of doctors |
| 摘要点击 6 全文点击 0 投稿时间：2025-11-26 修订日期：2026-01-24 |
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| 中文关键词 远程会诊; 激励机制; 医生行为; 博弈论 |
| 英文关键词 teleconsultation; incentive mechanism; doctor's behavior; game theory |
| 基金项目 国家自然科学基金资助项目(72501263); 国家资助博士后研究人员计划(GZC20241540); 中国博士后基金面上项目(2025M770800)；中原科技创新领军人才项目(244200510047) |
| 投稿方向 医疗运营管理 |
| 作者 | 单位 | 邮编 | | 周翠华 | 郑州大学管理学院 | 450001 | | 高盼 | 郑州大学管理学院 | | | 卫东乐 | 郑州大学管理学院 | | | 翟运开* | 郑州大学管理学院 | 450001 |
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| 中文摘要 |
| 面对我国医疗资源不足且分布不均的挑战, 远程会诊虽理论上可推动分级诊疗实现供需均衡, 实践中却陷入``叫好不叫座'困境. 本文突破现有文献将医院简化为``黑匣子'的局限, 基于管理者与医生目标冲突的运营复杂性, 构建二者在远程会诊中的博弈模型, 聚焦探讨按盈余分成机制相对于传统按诊疗量补贴机制的激励作用. 发现: (1) 按盈余分成机制特定条件下可提升远程会诊利用率, 但反直观地, 当线下转诊边际效益较低时, 其可通过降低传统线下患者量而非转诊患者量来实现这一效果; (2) 即便盈余分成比例较高, 管理者仍倾向采用盈余分成机制; (3) 两种机制下, 博弈双方均可在特定条件下达成共赢. 本文通过解构多主体博弈揭示远程会诊利用率不足的微观机制, 为分级诊疗与数字医疗融合完善提供新范式. |
| 英文摘要 |
| Faced with insufficient and unevenly distributed medical resources in China, teleconsultation—though theoretically able to balance supply and demand by promoting the implementation of the hierarchical medical system—has fallen into the ``Popularity but no practical effect" dilemma in practice. Moving beyond the "black box" hospital assumption, this study constructs a game-theoretic model incorporating the operational complexity arising from the differing goals of hospital managers and doctors. It compares the incentive effects of a profit-sharing mechanism with traditional fee-for-service subsidies. Key findings include: (1) Profit-sharing can increase teleconsultation use, but counterintuitively, when the marginal benefit of offline referrals is low, this is achieved by reducing traditional offline patients rather than referrals; (2) Managers prefer profit-sharing even at a high sharing ratio; (3) Both mechanisms can enable win-win outcomes under specific conditions. This multi-agent analysis reveals the micro-mechanisms of low adoption, offering a novel paradigm for integrating hierarchical and digital healthcare. |
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