Yeung Ho-Man, Makkapati Shreya
Department of Medicine, Temple University Hospital, Philadelphia, PA, USA.
J Community Hosp Intern Med Perspect. 2023 Jan 10;13(1):20-24. doi: 10.55729/2000-9666.1135. eCollection 2023.
Inpatient hospital costs have been increasing exponentially in the United States. Part of this increase is attributed to over and undertreatment, leading to higher costs and potential patient harm. Research improving clinician-patient interactions can help minimize and optimize the costs. Game theory has the ability improve clinician-patient interaction by modeling outcomes. Using variations of game theory, the bad doctor bad patient stigma can reframed to incentives. We believe the use of different models (prisoner dilemma, centipede game, assurance game, and chicken game) can outline the challenges faced during common inpatient scenarios, including end of life conversations and aggressive procedures. Applying game theory to multiple inpatient scenarios may also assist with analysis during morbidity and mortality conferences and quality improvement projects.
在美国,住院医院费用一直在呈指数级增长。这种增长的部分原因是过度治疗和治疗不足,导致成本更高以及对患者造成潜在伤害。改善医患互动的研究有助于将成本降至最低并实现优化。博弈论有能力通过对结果进行建模来改善医患互动。利用博弈论的变体,可以将“坏医生-坏患者”的污名重新构建为激励因素。我们认为,使用不同的模型(囚徒困境、蜈蚣博弈、确信博弈和懦夫博弈)可以勾勒出常见住院场景中面临的挑战,包括临终谈话和激进治疗程序。将博弈论应用于多个住院场景也可能有助于在发病率和死亡率会议以及质量改进项目中进行分析。