Equilibrium model for hospital competition based on patient choices and government subsidies

被引:0
作者
Lin G. [1 ]
Chen J. [1 ]
Chen P. [2 ]
机构
[1] School of Management, Shanghai University, Shanghai
[2] School of Business, Yangzhou University, Yangzhou
来源
Xitong Gongcheng Lilun yu Shijian/System Engineering Theory and Practice | 2021年 / 41卷 / 12期
基金
中国国家自然科学基金;
关键词
Generalized Nash equilibrium model; Government subsidy; Hospital competition; Mixed complementarity system; Patient choice;
D O I
10.12011/SETP2020-3017
中图分类号
学科分类号
摘要
In order to study the competition strategies of medical institutions under market mechanism and government supervision, taking the current medical policies into consideration, we establish a nonconvex generalized Nash equilibrium model with upper bounds for demands of regional medical procedures based on patient choices and government subsidies. By introducing some auxiliary variables to deal with the fractional objective functions, we make use of the block coordinate descent method to decompose the nonconvex optimization problem into two convex subproblems and then use their Karush-Kuhn-Tucker conditions to transform them into a mixed complementarity system. Furthermore, to test the effectiveness of the considered model, we employ Python 3.7.3 to give some numerical experiments and the sensitivity analysis of the government subsidies and the hospital altruistic behaviors. The numerical results indicate that, with the increase of government subsidies, the prices of medical procedures together with marginal utility decrease gradually, whereas the quality of medical procedures, the level of cost control, and the total benefits increase accordingly. This reveals that increasing total government subsidies modestly can alleviate the difficulties caused by patients' seeking treatment and hospital operational management. In addition, when the altruism is introduced, the operational efficiency of hospitals increases to some extent, which means that establishing and improving regulatory system of hospital altruism is helpful in increasing economic benefits and promoting sustainable development in the medical markets. © 2021, Editorial Board of Journal of Systems Engineering Society of China. All right reserved.
引用
收藏
页码:3163 / 3177
页数:14
相关论文
共 35 条
  • [11] Gaynor M, Moreno-Serra R, Propper C., Death by market power: Reform, competition, and patient outcomes in the national health service, American Economic Journal: Economic Policy, 5, 4, pp. 134-166, (2013)
  • [12] Jiang J H., Effects of competition on the expense and quality of medical service-Based on the data of Guangdong province, Research on Economics and Management, 36, 3, pp. 88-96, (2015)
  • [13] Bloom N, Propper C, Seiler S, Et al., The impact of competition on management quality: Evidence from public hospitals, The Review of Economic Studies, 82, 2, pp. 457-489, (2015)
  • [14] Nagurney A, Li K., Hospital competition in prices and quality: A variational inequality framework, Operations Research for Health Care, 15, pp. 91-101, (2017)
  • [15] Siciliani L, Straume O R., Competition and equity in health care markets, Journal of Health Economics, 64, pp. 1-14, (2019)
  • [16] Brekke K R, Siciliani L, Straume O R., Competition and waiting times in hospital markets, Journal of Public Economics, 92, 7, pp. 1607-1628, (2008)
  • [17] Sivey P., The effect of waiting time and distance on hospital choice for English cataract patients, Health Economics, 21, 4, pp. 444-456, (2012)
  • [18] Gan X Q, You M X, Hu K., Reimbursement gap, patient behavior and medical expenses-A three-stage dynamic game analyses, Systems Engineering-Theory & Practice, 34, 11, pp. 2974-2983, (2014)
  • [19] Chen Y, Zhou W H, Hua Z S, Et al., Pricing and capacity planning of the referral system with delay-sensitive patients, Journal of Management Sciences in China, 18, 4, pp. 73-83, (2015)
  • [20] Gutacker N, Siciliani L, Moscelli G, Et al., Choice of hospital: Which type of quality matters?, Journal of Health Economics, 50, pp. 230-246, (2016)