| 引用本文：曹剑涛,李志建,马进.公立医院规模扩张的内因及抑制策略——基于演化博弈理论视角[J].中国卫生政策研究,2013,6(2):34-39 |
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| 公立医院规模扩张的内因及抑制策略——基于演化博弈理论视角 |
| 投稿时间：2012-01-02 修订日期：2012-01-30 PDF全文浏览 HTML全文浏览 |
| 曹剑涛1, 李志建1, 马进2 |
| 1.上海交通大学安泰经济与管理学院;2.上海交通大学公共卫生学院 |
| 摘要:利用博弈论工具，研究公立医院在“有限理性”的情况下规模扩张的演化博弈，探讨它们如何实现“进化稳定性策略”，分析它们扩大规模的内在机理，从而发现获取更多医疗资源、诱导需求、扩大医疗市场份额、人事升迁机制等因素是公立医院扩张的内在助因；如果这些因素存在而且大到一定程度，则纵然公立医院是“有限理性的”，也必然会选择“扩张规模”策略。最后，提出抑制公立医院规模扩张的对策：注重医疗资源分配的公平性；推动公立医院人事改革，创新院长激励和考核机制；合理分流大医院就诊的患者；减少诱导需求；加强公立医院监督，增加公立医院扩大规模的成本。 |
| 关键词:公立医院 医院规模 有限理性 演化博弈 进化稳定策略 |
| 基金项目:国家自然科学基金（71273175） |
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| The internal factors and the inhibition strategies on public hospitals’ scale expanding: Based on the perspective of Evolutionary Games |
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| Abstract:By employing game theory, this paper focuses on studying public hospitals’ evolutionary stable strategy (ESS), analyzes the internal mechanism for their expanding scale, and concludes as follows: such intrinsic factors as attaining more medical resources, inducing patient demand, expanding medical service market share and promoting staff’s mechanism play key roles in public hospitals’ scale expansion， and when the mentioned factors exist, public hospitals still tend to select expanding strategy in spite of their bounded rationality. Finally, several proposals are raised for inhibiting public hospitals’ scale expanding, such as strengthening the equity of medical resources allocation, promoting reform of the public hospital personnel system, making reasonable split flow of tertiary hospitals’ patients, and other similar ideas. |
| Key words:Public hospital Hospital scale Bounded rationality Evolutionary game Evolutionary stable strategy |
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