Abstract:The medical dispute has been the important contradiction restricting the development of harmonious society, while government regulation will play an important role in strategy choice of both sides when resolving disputes. This article analyzes the influence of the degrees of governmental regulation to doctor-patient strategies by building the doctor-patient evolution game model. The study results indicate that different degrees of regulation result in different strategy profile, different regulation efforts to doctor and patient will determine the operation status and behavior choice separately. The government's improvement of the regulation standard to hospitals and patients will gradually raise the probability of hospitals to operate specifically, regulate patients' routes and ways to safeguard legal rights, and finally normalized the behaviors of both sides. The behaviors of "medical disturbance" are somehow a way to expose the operation status of hospitals; different self-positioning of the government in medical disputes determines different strategies, which resulted in a relatively big difference in the results of the medical disputes. Finally, this article discusses the evolution results under the circumstances of insufficient governmental regulation and improper regulation strategies combing with the Putian Medical Group and Medical Dispute in Nanping, Fujian.
管欣, 张哲薇, 陈张蕾, 高杨. 政府规制下的医患纠纷演化博弈模型[J]. 系统工程理论与实践, 2019, 39(12): 3151-3162.
GUAN Xin, ZHANG Zhewei, CHEN Zhanglei, GAO Yang. The evolutionary game model of medical dispute under the regulation of the government. Systems Engineering - Theory & Practice, 2019, 39(12): 3151-3162.
[1] Pan Y, Yang X H, He J P, et al. To be or not to be a doctor, that is the question:A review of serious incidents of violence against doctors in China from 2003-2013[J]. Journal of Public Health, 2015, 23(2):111-116. [2] Schneider U, Ulrich V. The physician-patient relationship revisited-The patient's view[J]. International Journal of Health Economics and Management, 2008, 8(4):279-300. [3] Kenkel D. Consumer health information and the demand for medical care[J]. Review of Economics & Statistics, 1990, 72(4):587-595. [4] 吕本友. 医疗服务市场的规范管理研究——信息不对称现象分析[J]. 管理评论, 2005(4):42-47.Lü B Y. Research on standardized management of medical service market-Analysis of information asymmetry[J]. Business Review, 2005(4):42-47. [5] Liang C, Gu D, Tao F, et al. Influence of mechanism of patient-accessible hospital information system implementation on doctor-patient relationships:A service fairness perspective[J]. Information & Management, 2016, 54:57-72. [6] Dranove D. Demand inducement and the physician/patient relationship[J]. Economic Inquiry, 1988, 26(2):281-298. [7] 董香书, Proochista Ariana. 为何农村医生工作不满意?——工作收入、医患关系和工作满意度的实证研究[J]. 管理世界, 2012(11):77-88.Dong X S, Ariana P. Why are rural doctors not satisfied?-Empirical study on job income, doctor-patient relationship and job satisfaction[J]. Management World, 2012(11):77-88. [8] 杜艾桦. 和谐医患关系多维分析[J]. 医学与社会, 2011(12):65-66.Du A H. Multidimensional analysis of harmonious doctor-patient relationship[J]. Medicine and Society, 2011(12):65-66. [9] Aziz V M. Cultural aspects of the patient-doctor relationship[J]. International Psychogeriatrics, 2009, 21(2):415-417. [10] 任亚辉. 当前我国医患关系矛盾的原因与对策分析——对"经济人" 假设的反思[J]. 医学与哲学, 2007(5):27-29.Ren Y H. Analysis on the causation and countermeasure of doctor-patient conflict in China at present[J]. Medicine and Philosophy, 2007(5):27-29. [11] 温全衡, 纪春明. 基于患者满意度调查的医患关系研究[J]. 科学学与科学技术管理, 2007(S1):201-203.Wen Q H, Ji C M. Doctor-patient relationship research based on patient satisfaction survey[J]. Science of Science and Management of S&T, 2007(S1):201-203. [12] Kaba R, Sooriakumaran P. The evolution of the doctor-patient relationship[J]. International Journal of Surgery, 2007, 5(1):57-65. [13] 伍德志. 论医患纠纷中的法律与信任[J]. 法学家, 2013(5):1-19.Wu D Z. Discussion about law and trust in doctor-patient disputes[J]. Jurists Review, 2013(5):1-19. [14] Hui E. The contractual model of the patient-physician relationship and the demise of medical professionalism[J]. Hong Kong Medical Journal, 2005, 11(5):420-422. [15] Xu Z W. Contemporary healthcare crisis in China and the mission and responsibility of healthcare professionals[J]. Medicine and Philosophy, 2006, 27:1-6. [16] 刘德海, 陈东, 黄静. 管理越位现象:医患群体性事件社会网络的稳定性与效率[J]. 中国管理科学, 2016(1):169-176.Liu D H, Chen D, Huang J. "Management off Side" phenomenon:Stability and efficiency of social network in hospital-patient mass conflict[J]. Chinese Journal of Management Science, 2016(1):169-176. [17] Hall J A, Roter D L, Junghans B. Doctors talking with patients-Patients talking with doctors:Improving communication in medical visits[J]. Clinical & Experimental Optometry, 1995, 78(2):79-80. [18] 宋旭明. 医疗秩序管理重在实现医疗公正[J]. 管理世界, 2014(2):172-173.Song X M. Medical order management focuses on the realization of medical justice[J]. Management World, 2014(2):172-173. [19] Hesketh T, Wu D, Mao L, et al. Violence against doctors in China[J]. British Medical Journal, 2012, 345:e5730. [20] 赵金楼, 韩玉珍, 齐英. 信息不对称下政府行政部门的监管行为失效分析[J]. 管理科学, 2007(6):87-92.Zhao J L, Han Y Z, Qi Y. The disabled supervising behavior of governmental administrative sectors from the view of information asymmetry[J]. Journal of Management Sciences, 2007(6):87-92. [21] Smith J, Price G. The logic of animal conflict[J]. Nature, 1973, 246:15-18. [22] Smith J M. The theory of games and the evolution of animal conflicts[J]. Journal of Theoretical Biology, 1974, 47(1):209-221. [23] 郑君君, 韩笑, 邹祖绪, 等. IPO市场中风险投资家策略的演化博弈分析[J]. 管理科学学报, 2012(2):72-82.Zheng J J, Han X, Zou Z X, et al. Analysis on venture capitalists' strategies in IPO market based on evolutionary game[J]. Journal of Management Sciences in China, 2012(2):72-82. [24] 黄敏镁. 基于演化博弈的供应链协同产品开发合作机制研究[J]. 中国管理科学, 2010(6):155-162.Huang M M. Evolutionary game of cooperation mechanism for collaborative product development in supply chain[J]. Chinese Journal of Management Science, 2010(6):155-162. [25] 杨光, 刘新旺, 秦晋栋. 关于概率销售的动态演化博弈研究[J]. 系统工程理论与实践, 2017, 37(9):2231-2243.Yang G, Liu X W, Qin J D. Probabilistic selling strategy study based on dynamic evolution game theory[J]. Systems Engineering-Theory & Practice, 2017, 37(9):2231-2243. [26] 王先甲, 何奇龙, 全吉. 基于复制动态的消费者众筹策略演化动态[J]. 系统工程理论与实践, 2017, 37(11):2812-2820.Wang X J, He Q L, Quan J. Evolutionary dynamics of consumer's crowdfunding strategies based on replicator dynamics[J]. Systems Engineering-Theory & Practice, 2017, 37(11):2812-2820. [27] 张国兴, 高晚霞, 管欣. 基于第三方监督的食品安全监管演化博弈模型[J]. 系统工程学报, 2015, 30(2):153-164.Zhang G X, Gao W X, Guan X. Evolutionary game model of food safety supervision based on the third-party intendance[J]. Journal of Systems Engineering, 2015, 30(2):153-164. [28] 郭本海, 方志耕, 刘卿. 基于演化博弈的区域高耗能产业退出机制研究[J]. 中国管理科学, 2012(4):79-85.Guo B H, Fang Z G, Liu Q. Study of regional energy-intensive industry's exit mechanism based on evolutionary game[J]. Chinese Journal of Management Science, 2012(4):79-85. [29] 肖海燕, 王先甲. 政府参与模式下出行者出行方式选择行为的演化博弈分析[J]. 管理工程学报, 2010(2):115-118.Xiao H Y, Wang X J. A study of trip model choice behavior of traveler based on the evolutionary game under the participation of government[J]. Journal of Industrial Engineering, 2010(2):115-118. [30] 虞晓芬, 傅剑. 社会力量参与保障性安居工程演化博弈及政府规制[J]. 系统工程理论与实践, 2017, 37(12):3127-3136.Yu X F, Fu J. Evolutionary game and government regulation on social forces participating in affordable housing projects[J]. Systems Engineering-Theory & Practice, 2017, 37(12):3127-3136. [31] Friedman D. Evolutionary games in economics[J]. Econometrica, 1991, 59(3):637-666.