| 引用本文：卢建龙, 姜艳, 吕力琅, 秦悦, 张璐莹, 应晓华.医患委托代理关系的双向选择行为模型:基于信息传递与预期收益[J].中国卫生政策研究,2019,12(7):24-27 |
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| 医患委托代理关系的双向选择行为模型:基于信息传递与预期收益 |
| 投稿时间：2018-08-06 修订日期：2018-11-03 PDF全文浏览 HTML全文浏览 |
| 卢建龙1,2, 姜艳2, 吕力琅2, 秦悦2, 张璐莹1, 应晓华1 |
1. 复旦大学公共卫生学院 上海 200032;
2. 复旦大学附属肿瘤医院(复旦大学上海医学院肿瘤学系) 上海 200032 |
| 摘要:目的：构建医患委托代理关系的双向选择行为模型，并探索其影响因素。方法：收集整理委托代理模型、寻医行为和逆向选择行为等理论，结合相关文献等资料，进行理论逻辑分析和资料分析，构建综合双向选择理论的行为模型。结果：当前我国医患委托代理关系脆弱是导致医患关系紧张的主要原因。医患委托代理关系构建中的双向选择行为模型是动态、系统的，包含患者基于可获取信息的理性选择、医生基于信息优势的理性选择和心理学的非理性选择。患者医疗服务相关信息的可及性差、医生诊断治疗服务的选择成本低、预期损失和收益失衡是导致医患委托代理关系脆弱的主要因素。结论：医患委托代理关系构建中的双向选择行为模型是深入分析医患关系和供需关系的理论基础。良好的医患委托代理关系的建立需要提高信息质量、透明度和患者信息可及性，提高医生非理性选择的成本，降低医生理性选择的预期损失，提高医生理性选择的预期收益。 |
| 关键词:医患关系 委托代理关系 逆向选择 行为模型 |
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| The two-wayselection behavior model of doctor-patient principal-agent relationship: Based on information transmission and expected benefit |
| LU Jian-long1,2, JIANG Yan2, LV Li-lang2, QIN Yue2, ZHANG Lu-ying1, YING Xiao-hua1 |
1. School of Public Health, Fudan University, Shanghai 200032, China;
2. Fudan University Shanghai Cancer Center, Shanghai 200032, China |
| Abstract:Objective:To establish a two-way selection behavior model in the establishment of doctor-patient trust agency relationship, and to explore the influencing factors of the principal-agent relationship between doctors and patients. Methods:The theories of the principal agent model, behavior when seeking medical care and adverse selection behavior were collected and arranged, combined with the related literature and other second-hand materials. Thereafter, the theoretical logic analysis and second-hand data analysis were carried out to construct the behavior model of the comprehensive two-way selection theory. Results:Presently in China, the weak principal-agent relationship between doctors and patients is the main reason for the tension between them. In the construction of the aforementioned relationship, the two-way selection behavior model is dynamic and systematic, and includes rational choice of patients based on available information, rational choice of doctors based on information superiority and irrational choice of psychology. The low access to medical quality information, the low cost of choosing doctors' diagnostic services and the imbalance between expected loss and income constitute the main factors leading to the weakness of the principal-agent relationship between doctors and patients. Conclusions:The two-way selection behavior model is the theoretical basis for in-depth analysis of the relationship between doctors and patients and the relationship between supply and demand in the construction of doctor-patient principal-agent relationship. The improved transparency and accessibility of information, improved cost of selection of doctors, reduced expected loss and improved expected income of doctors are needed in order to establish a good doctor-patient agency relationship. |
| Key words:Doctor-patient relationship Principal-agent relationship Adverse selection Behavior model |
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