Discretion, Cooperation and Information in Medical Profession's Performance: Game Approach to Risk Management in Japanese Hospital

摘要

The purpose of this paper is to clarify the reason of cognitive gap of medical professions to the risk, from the view point of game, and to examine how much the acquisition and sharing of medical information can mitigate the factor of such gap. Significant characteristic of present medical care is the Team by the physician, nurses, and other co-medical professions. In recent years, the medical error with respect to diagnosis, treatment, nursing, medication and so on, in which the Team should be demonstrated are occurring frequently in Japan, and also it is said that many of them are due to the lack of communication between physician and nurse in the team. In this paper, we regard the occurrence of error in medical procedure as, not only, the result of human error, but also, as the result of risk perception gap which induce 'the dilemma' when the medical professions want to maximize their utility. We indicate especially the possibility of unsuitable action by the physician and nurse when they get involved their action under the complete information game situation as background of risk perception gap. Then we point out the mechanism of decision making in terms of cooperation action under Bayesian game model with paying our attention to the modification of the decision making by the ex-post acquisition of the medical information. Finally we examine whether the gain of certain medical information would make really the physician and nurse more sensible against the risk, arid it leads them to do cooperative behavior in Team.