Study On Benefit Game And Optimization Strategy Of Contractual Community Medical Service

As a new medical system,the contractual community medical service(also known as "family doctor signing service")is being piloted all over the country,but there are some resistance in the pilot.A series of problems,such as insufficient publicity,insufficient supply capacity of community medical and health institutions,large gap in family doctors and low recognition of residents,have affected the continuous progress of the contractual community medical treatment.These problems largely due to contractual interest game between stakeholders in the contractual community health service,their game behavior will directly affect the interests of all parties’ subject to affect the sustainable development of the system.Therefore,it is urgent to study the interest game behaviors of the stakeholders of the contractual community medical service,and find the optimization strategy to alleviate the above contradictions.The paper focuses on various types of the conflicts of interest among stakeholders and stakeholders of the contractual community medical service,how to encourage to the system design stakeholders from the conflicts of interest to the game equilibrium,how to avoid conflicts of interest in the future,regulate the behavior of each main body to promote the effective advance of signing service and the research on four major issues.In general,the paper focuses on the following four aspects: Firstly,it analyzes the development status of the contractual community medical treatment in China and finds out the contradictions or problems in it.Secondly,study the conflicts of interest between the subjects by using the extended expression and the strategic game.The extended game model of government-community hospital-community residents’ financial input is constructed and also constructed the game model of supervision game between government and community hospitals and Game model of compensation mechanism between government and family doctor and the strategic game model of doctor-patient relationship game.Thirdly,the game model is analyzed in equilibrium.Fourthly,theoptimization strategy of system design is explored from two aspects of subject and organization.The research results of this paper can be for the further promotion of contractual community health services to provide theoretical and policy basis,to promote the establishment of classification system of diagnosis and treatment,medicine and health care system reform,ease the problem of "difficulty and high cost of seeing a doctor" has important significance.