Considering The Social Network Model Of Doctor-patient Principal-agency Model

With the continuous development of our economy and society, the relationship between doctors and patients has increasingly become the focus of social concern and difficult problems.As medical identification and judicial proceedings become more complex、the lack of trust between doctors and patients, patient disputes triggered by the unexpected incidents involving mass participation worsening, and resulting in adverse social impacts, such as Nanping medical alarm event、Hengyang vicious insult event、Harbin Medical University wounding events.The cause of medical dispute involves many factors, including the vital interests of both doctors and patients groups、personal cultural awareness、ethical standards, and national health laws and regulations、medical units management and so on. On the doctor-patient relationship has a clear understanding, Preventing and dealing with the occurrence of medical disputes, the medical and health system faced a new challenge.The deep-seated reason of doctor-patient relationship’s deterioration is the lack of interest coordinating mechanism, the key of resolving conflicts between doctors and patients is to find the proper-coordinated approach of the conflicts between doctors and patients,building a harmonious doctor-patient relationship of trust. However, the problem is not just a conflict between doctors and patients.As the patients group is not only the patients themselves, but also including occupational medical trouble、relatives of patients, the medical community including doctors、 Medical Affairs Division、nurses, etc. so that the doctor-patient relationship issues becomes more complex.The distribution of interests between patients group and the distribution of responsibilities and benefits between doctors group has also become the focus of our attention.Based on this situation, we urgent need to establish a interest coordinating mechanism to Safeguard the interests of the masses and social stability.This paper studies the distribution of interests and responsibilities between the doctor-patient relationship’s different groups: (1) Paper uses the double principal-agent model to analyze the Benefits coordination problems of hospitals, doctors and patients. This chapter references the paper of Mabenjiang which is published in "Economic Research", analysising the doctors’optimal level of effort and the proportion of interests and responsibilities. First, analysising the influencing factors of interests between the doctors and patients, establishing the hospital-doctor and patient-hospital principal-agent model respectively. Then, the paper considered the behaviors of the experienced patients and hospital in the medical services, namely in the analysis of the patient-hospital agency relationship, considered the hospital-doctor’s behavior. The results shows when a disease can not be completely cured, medical side bear the full responsibility is not optimal contractual arrangements, the responsibility should be shared by the hospital and the doctors. Level of effort between the two sides are mutually reinforcing, if the hospital want the doctors to work harder, it also should provide the best possible health care environment, and the doctor must be given a certain proportion of responsibilities and interests.(2) Papers built a bilateral agency model to analysis the doctor-patient relationship, and takes into account the doctor’s moral hazard and the patient’s moral hazard, namely bilateral moral hazard problem, established bilateral moral hazard principal-agent model patient, get some inspirations from the patient’s behaviors. Based on this, further introduced the government, in the context of rural medical insurance, analysising the responsibilities and interests of the patient, the hospital and the doctor. Models conclusion shows, when introducing medical insurance, the patient’s proportion of responsibility increased, the degree related to the reimbursement of prescriptions. Moreover, the patient’s efforts level Improved, while the the patient’s effort declined.(3) Based on the typical Jackson-Wolinsky model, the paper further considers the practical characters of social network in hospital-patient conflicts including individual (i.e. node) heterogeneity, transfer payment and decreasing connecting cost, and then applies exhaustive search method to analyze the stability and efficiency of social network Jackson-Wolinsky model in hospital-patient conflicts. The results show that star network structure is stable and efficient, when the direct connecting cost is lower. Along with the connecting cost and benefit rising, there are various forms of social networks contented with stability and efficiency simultaneously. This social network connecting model reveals conditions for the phenomenon of "management offside" in various social organizational networks:The key factors are to trade-off between the connecting cost and benefit.