Operations Management In Competitive Healthcare Service Market

Under the general trend of peace and development in the modern era,people's health requirements have been gradually raised.For example,reforms in the United Kingdom's National Health Service in recent years have focused primarily on increasing the flexibility of patient care choices and encouraging hospitals to compete in the healthcare market.Hong Kong SAR Government in 2010 proposed a Medicare scheme to encourage citizens to buy private health insurance to address longer waiting times and heavy financial pressure in public hospitals by directing more patients to private hospitals,and this plan in 2016 has entered the full implementation phase.Therefore,the issue of operation management in the competitive healthcare market is an urgent problem to be solved by governments and hospitals in various countries.In the second chapter,we use the Hoteling model to describe the market of healthcare service coexisting in public and private hospitals,and establish a dynamic model with maximum total welfare of the public hospital and patients as the objective function.Through the Pontryagin maximum principle,we solve the public hospital decision-making number of medical treatment,and analyze the trend of decision-making number,average waiting time and instantaneous objective function in public hospital over time.In addition,we also analyze how the patients' sensitivities about the waiting time,the distance costs and the price cost affect the patients' choice from the patients' perspective.Finally,we provide the government,hospitals and patients with the rationalization proposals combined the results of numerical simulation analysis.In the third chapter,we establish a mixed duopoly game model within a queuing system.Specifically,we consider the competition between a public hospital and a private hospital in an elective care market considering two settings:with and without the tax-subsidy policy.Under each setting,we obtain the hospitals' optimal operational decisions under three scenarios: no patient having PHI(as a benchmark),all patients having PHI(Compulsory PHI policy)and part of patients having PHI(Voluntary PHI policy).Then we examine the effects of PHI and government policies on patients' waiting time,patients' total welfare,private hospital's profit and social welfare.Our results show that tax-subsidy policy is an effective policy to reduce waiting time and improve total patient welfare while PHI always benefits the private hospital.And,interestingly,the role of PHI on total patients' welfare is rather different when part of patients having PHI under the two cases.In addition,under Voluntary PHI condition,we find there is an optimal proportion of patient regarding the total patient welfare.