Optimization And Simulation Of Healthcare Insurance Payment Mechanism For Social Welfare Maximization

Social security is a national security strategy and one of the most critical social and economic systems in a modern country.My country has established a universal healthcare insurance system to provide a strong guarantee for people’s health.In the construction of the healthcare system,an effective reimbursement scheme can significantly improve the performance of a public healthcare system.The current healthcare insurance payment mechanism in my country is still based on Fee for Service.In this mode,although the hospital’s service enthusiasm can be mobilized,it is easy to cause excessive medical behavior,which causes a waste of healthcare resources.To this end,this article is based on the Bundled Payment model currently under reform,taking full consideration of factors such as patients’ bounded rationality,with the goal of maximizing social welfare,and conducting an in-depth study on the optimization of the medical insurance payment mechanism,with a view to solving the medical insurance payment mechanism Provide a theoretical basis for the selection and use of.However,the current research assumes that patients’ decision-making in the healthcare process is made under rational circumstances,that is,rationally considering cost and quality to make decisions.However,in reality,many patients’ healthcare process reflects a lot of bounded rationality,that is,more consideration is given to factors such as individual preferences and individual risk attitudes.Aiming at the problem mentioned above of modeling and optimization analysis of healthcare payment schemes that considers the limited rationality of patient decision-making,this paper finds the minor rationality factors such as patient’s consumption time and expenditure and establishes a three-stage Stackelberg game model.In the model,queuing theory is first used to reflect the relationship between patient arrival rate and reimbursement rate and other influencing factors.Then the decision-making process and interaction are evolved.In the game,the government is in a dominant position.The government,hospitals,and patients act in sequence in the three stages,which shows the mutual influence of decision-making among the three.By analyzing the nature of the model,the selection strategy of the medical insurance payment mechanism is obtained.Next,this article optimizes the solution based on the established model and designs a healthcare budget expenditure allocation strategy for maximizing social welfare from the government’s decision-making perspective during the healthcare payment process.Through experiments,this allocation strategy can better optimize the utilization rate of healthcare insurance funds and effectively increase the group income of patients.Based on the established three-stage Stackelberg game optimization model that considers patients’ bounded rationality,this paper designs and implements a healthcare payment decision support simulation system.The healthcare payment decision support simulation system can simulate and predict various welfare indicators of different types of patients when different reimbursement rates are adopted.It can provide decision-making support for healthcare insurance management institutions and large medical institutions.It gives the government a basis for scientific decision-making,provides hospitals with plans for the use of healthcare resources,and provides patients with references for seeking treatment.