Patient Choice Of Service Pattern In The Healthcare System

The difficulty in the healthcare system reform is descripted as "magic spell" by the economists. Since the founding of New China in 1949, the government consists in improving the efficiency of the healthcare system in order to improve the resident’s medical benefits. Our healthcare system has passed through several stages. In the planned economy period, the government provides the healthcare service. After its entry of market economy, the government encouraged market providing the healthcare service. Profit-making hospital and healthcare industry emerged. But the outbreak of SARS reminded that the healthcare service is public good, and highlighted that the medical market-oriented reform is not the right direction. Then the medical reform considered changing direction. In 2009 officially launched the new medical reform, medical reform mainly includes deepening the reform of public hospitals and encouraging social construction, improving the medical insurance policy, adjusting the price of medical services and the establishment of clinics grading system. Our country’s health care system has been looking for the direction of reform in the dark. After decades of efforts, the healthcare system has achieved remarkable results in the four aspects:medical services, the production and distribution of medicines, medical security and health. But "the medical treatment is difficult, expensive and hard to recover", problem of imbalance distribution of medical resources, tense doctor-patient relationship still exist. The "difficult" is mainly reflected in the terms of "three long and one short in treatment process", which refers to that the registration line, waiting ling, charging line are long, while the treatment time is very short. The "supporting medicine with drugs" phenomenon and overtreatment phenomenon exist, which results in residents paying unnecessary medical expenses. Due to the imbalance distribution of medical resources, the resident in either condition, serious or minor, runs to the big hospital requiring for treatment. The data show that the best hospitals, which only occupy 0.21% of the whole medical market, sever 19.18% of patients. It results in overcrowded in large hospitals. Meanwhile, the big hospitals absorb a large number of patient resources, which makes the hospital siphon a large number of outstanding medical professionals. The grassroots medical institutions and medical facilities level is relatively weak. The resources are not used effectively and efficiently.The medical service product is different from the general physical products. In addition to features of intangible, service product can’t touch, customer participation, it also has features of public welfare, heterogeneity, weak elastic (not too sensitive to price changes), characteristics of asymmetric information. Based on the characteristics of the medical service products, patient’s service choosing behavior also affects by a number of factors, such as the price of medical services, waiting time and traveling costs. The patient’s behavior influents the medical institutions operating decision. With the acceleration of the process of China’s aging population, increasing of chronic patient, and resident’s attention to health promotion, China’s residents’ demand for medical services will further increase in the future. Strengthening the medical service management and operation level becomes particularly important.At present, residential medical health services mainly include traditional hospital (offline medical care) and online medical care. According to the traditional medical mode, there has been a "centralized" and "decentralized" argument. In this article, we consider price and service capacity decision in the healthcare system with patient behavior, and optimization of price and capacity in the medical service system in the present of traveling cost. Online health in China is still an emerging industry, covering areas including:registration services, online health care and monitoring, telemedicine, online diagnosis and treatment services, and medical services, medicines and medical supplies business, online inquiry related network booking. The residents’ cognition of the online medical service is relatively limited. With the popularity of the Internet and mobile Internet, and hospital information level increasing, online medical service industry has a very broad prospect. Online medical help to break the medical information barriers, improve patient’s medical experience, reasonable distribution of patients, so the popularity of online health becomes very important for online medical treatment. This paper studies the behavior influencing factors through the questionnaire survey method, as well as channel choice preference between online medical and traditional medical treatment.The contribution of this thesis can be summarized as follows:(1) We consider the traditional model of patient selection behavior In this paper.We analyze price and capacity competition in both centralized system and separated system. Furthermore, we study the influence of government regulation on the market capacity. The results show that the centralized system can reduces the waiting time through the capacity pooling. In the short run, for a given capacity, the monopoly serves more patients than the competition system. In the long run, the monopoly provides higher capacity but charges higher service price. (Finally, we study the role of price regulation where the healthcare service system may use capacity to compete for customers. We obtain that it will reduce the service provider’s incentive to offer higher capacity. Therefore, it lowers the social welfare.) Our research find that if the government implements price regulation on monopoly healthcare institutions, the service providers’incentive to offer higher capacity will be reduced, thus lowering the social welfare.(2) We consider the effect of transportation cost on the patient’s choice behavior. The customer incurs a travel cost of driving to the service facility. The travel cost, used to characterize the customer heterogeneity, discourages the consumption of the service. Anticipating customers’ behavior, the service provider chooses the price and/or capacity to maximize its own profit. We obtain that (1) it is not in general optimal for the service provider to capture the whole market either in the short-run pricing model or in the long-run pricing and capacity decision model and (2) profit maximization results in a smaller served market size than the socially desired. These results vary greatly from the case where there is an absence of travel cost. We further demonstrate that the social welfare maximization for a service facility located at the extreme points can be achieved by moving its location to the central point, which is also in the service provider’s own interest to do so.(3) We establish an online medical patient selection behavior model. Based on the technology acceptance model, we test the hypothesis and analysis of the influencing factors of online care users. The perceived risk is also considered in our model. The technology acceptance model (TAM) mainly focus on analysis of the information technology, and the application of general acceptance and use of online shopping, the influence factors and knowledge alliance information technology acceptance behavior of Internet knowledge is studied, but the medical service is a special service. Due to the lack of medical resources and the general public the medical resources for integration of medical resources, and the Internet, will greatly improve the situation of lack of medical resources in China. Based on the information technology acceptance model, constructing the user acceptance of online medical model provides a way to explore the influence factors of online medical service.(4) Discuss the negative factors in the user perception of online medical services, and the relationship between the psychological contract and the user service channel adoption and user preferences are studied. User perception between negative factors and the adoption of psychological contract between the user adoption willingness and channel preference plays a mediating role. The study of how the negative factors affect the final user adoption is rare. This study discussed the influence of these factors, and the relationship between the channel preference and adoption. Our study has built a model to deepen the information technology acceptance model in the medical services system.