【作者】 王文杰；

【导师】 段治平；

【作者基本信息】 山东科技大学 ， 管理科学与工程， 2009， 硕士

【摘要】 “大处方”普遍存在,药价虚高,医德下降等不良现象,造成了医疗市场的混乱,和看病难,看病贵的现实。本文正是基于此,从现行医疗制度下医患保三方的博弈来探讨医疗体制的改革。文章首先论述了博弈论与信息经济学的中的委托-代理理论,紧接着对我国现行医疗机构管理体制,医疗价格收费政策和医疗保障体制进行了简述,并对其中存在的问题进行了分析。在第四章中,基于信息不对称,分别对医患,医保和患保利用委托-代理理论构建了数学模型,最后构建了医患保三方博弈模型。医患博弈中对患者求医过程的分析得出了医生诱导和保护性医疗等现象出现的原因。在患保博弈中,对骗保现象构建了博弈模型,指出了由于监管成本高和信息不对称等原因,使得骗保现象在我国尤为突出。在医保博弈中,根据医院和保险公司利益最大化来确定医院和保险公司的支付函数,进而构建双方的合同关系。医保合作不仅可以使双方都获得最大收益,又可以完全消除保险公司“道德风险”和“逆选择”风险,实现双赢。文章最后是相关政策建议。首先政府必须提供营造公平竞争的环境,提高效率,还要从筹资方面发挥主导作用。其次,要加强信息制度的建设,消除患者就医时的信息不对策划的状况。更多还原

【Abstract】 The phenomenon such as big prescription, widespread high prices, bad ethics, cause the confusion in medical market of China and the reality of difficulty and cost. Based on this, this article explores the health care system reform from the existing tripartite security under the doctor-patient game.The article first discusses principal - agent theory of game theory and information economics, followed by medical institutions of our existing management system, medical care prices and health care charging policy for the security system on, and the problems which have been analyzed. In the fourth chapter, based on the information asymmetry, the article uses principal - agent theory to build a mathematical model of the patient, medical and insurance company respectively and finally constructs a tripartite game model. Analysis of the treatment of patient explains the reason of induction and the protection of doctors. In the health insurance game between patient insurance company, the model is constructed, pointing out the high cost of regulation and information asymmetry and other reasons, make the phenomenon particularly prominent in our country.In the health insurance game, according to maximization of the interests of hospitals and insurance companies, build the relationship between the two sides of the contract. Co-operation can not only get the most income of both sides, but also eliminate" moral hazard" and "adverse selection" risk to achieve a win-win situation.Related policy recommendations are at last. First of all, the Government must provide to create the Environment of fair competition, and improve efficiency, but also play a leading role from in the funding. Secondly, it is necessary to strengthen the information system, and eliminate the situation of information asymmetry.更多还原