基于价格敏感患者的医疗服务协调机制研究

当医疗服务市场执行医疗费用分担制度时，由于患者收入水平存在差异，部分患者可能会因对价格更敏感而不去医院就诊.一种可能的解决办法是对贫困患者提供额外的补助使其能够去医院就诊.首先，为一个由政府、医疗服务提供者和价格敏感异质患者三方构成的医疗服务系统建立一个Stackelberg博弈模型.其次，运用逆向归纳方法，研究了博弈的均衡解及其性质.最后，将医疗服务均等化和非均等化两种情形进行了比较.研究结果发现，当市场需求较小时政府应采用免费医疗制度；反之，采用医疗费用分担制度.当患者的等待敏感度或单位服务成本中等大小时，患者的自付额和贫困患者的额外补助额均达到最大.此外，研究发现医疗服务均等化政策不仅能减少贫困患者的自付额，也通常有助于降低普通患者的自付额.

On healthcare coordination mechanism based on price-sensitive patients

When the healthcare service market implements the medical cost sharing system, some patients may not go to the hospital because they are more sensitive to price due to differences in patients' income levels. One possible solution is to offer poor patients extra subsidies to get them to hospital. First, a Stackelberg game model is established for a healthcare system composed of government, healthcare provider and price-sensitive heterogeneous patient. Secondly, the equilibrium solution and its properties of the game are studied by backward induction. Finally, the equalization and non-equalization of medical services are compared. The results show that when market demand is low, the government should choose the free medical care system and choose medical cost sharing system otherwise. When patient's waiting sensitivity or the unit service cost is medium, both the patients' self-payment and the poor patients' additional subsidy are the largest. In addition, the equalization subsidy policy can not only reduce the self-payment of poor patients, but also reduce the self-payment of common patients.