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Healthcare Supply Chain Network Coordination Through Medical Insurance Strategies with Reference Price Effect

机译:具有参考价格效应的医疗保险策略与医疗保健供应链网络的协调

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摘要

China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of attaining sustainable development of the social healthcare system in China is that the number of hospital admissions is disproportionate. Superior hospitals are overcrowded, whereas subordinate hospitals are experiencing low admissions. In this paper, we apply the game theory model to coordinate the healthcare supply chain network, which is composed of the government, medical insurance fund, superior hospitals, subordinate hospitals and patients. Especially by taking the reference price effect into account, this paper analyzes different medical insurance reimbursement strategies and their influence on patient choice and the healthcare supply chain network. The result shows that the reference price effect increases the leverage of medical insurance, guides patients’ choice, optimizes the allocation of medical resources and reduces the medical expends. In comparison to a decentralized decision- making strategy, a centralized decision- making strategy can stimulate both superior hospital and subordinate hospital’s cooperative intentions which benefits the social healthcare system.
机译:中国已经建立了全民医疗保险体系,个人的自付费用有所下降,但是,中国人的平均医疗保健支出和整个社会的支出却大大增加了。阻碍中国社会医疗体系可持续发展的主要挑战之一是住院人数不成比例。上级医院人满为患,而下级医院的入院率低。在本文中,我们采用博弈论模型来协调由政府,医疗保险基金,上级医院,下属医院和患者组成的医疗保健供应链网络。特别是考虑到参考价格的影响,本文分析了不同的医疗保险报销策略及其对患者选择和医疗保健供应链网络的影响。结果表明,参考价格效应提高了医疗保险的杠杆率,指导患者的选择,优化了医疗资源的分配并减少了医疗费用。与分散决策策略相比,集中决策策略可以刺激上级医院和下级医院的合作意图,从而有利于社会医疗体系。

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