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基于政府监管下医生和患者医疗事故的演化博弈理论和模拟。

Evolutionary game theory and simulations based on doctor and patient medical malpractice under government regulation.

机构信息

Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.

Information Ministry of Library, Qilu University of Technology, Jinan, 250100, China.

出版信息

Sci Rep. 2023 Oct 25;13(1):18234. doi: 10.1038/s41598-023-44915-9.

DOI:10.1038/s41598-023-44915-9
PMID:37880335
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10600196/
Abstract

Physicians-patients are the two crucial participants in medical malpractice. The government, as the central authority responsible for addressing medical malpractices, plays a pivotal role in this matter. Guided by governmental agencies, its regulations, administrative orders, and policies serve as the primary governance mechanisms to address medical malpractice, providing an effective means to balance the doctor-patient relationship and foster social harmony and stable development. A doctor-patient evolutionary game model developed based on the principles of information asymmetry and finite rationality. The study explores the strategic decision-making process of these two players within the context of medical malpractice. Through the manipulation of various parameters, the model's evolutionary equilibrium strategy is demonstrated using Vensim PLE Version 6.4 simulation. The findings reveal that government regulation, patient cognition, and the benefits associated with standardized medical practices are the pivotal factors influencing the doctor-patient evolutionary game system under government regulation. It is possible to mitigate medical malpractice through adjusting relative weights of differing strategic options, adding penalties for unlawful conduct, and normalizing malpractice charges on the basis of physicians' income from standardized practice. To effectively address medical malpractice, proposed measures include adjusting the regulatory framework, reasonably determining the strength of regulations regarding medical practitioners' illegal practices and patient medical malpractice behavior, diversifying regulatory approaches, establishing comprehensive physician-patient management systems for information to resolve medical malpractices.

摘要

医患双方是医疗事故的两个关键参与者。政府作为解决医疗事故的中央主管部门，在这一问题中起着关键作用。在政府机构的指导下，其法规、行政命令和政策作为解决医疗事故的主要治理机制，为平衡医患关系、促进社会和谐稳定发展提供了有效的手段。本文基于信息不对称和有限理性原则，构建了医患演化博弈模型，探讨了医疗事故背景下医患双方的策略决策过程。通过对不同参数的调控，运用 Vensim PLE Version 6.4 仿真演示了模型的演化均衡策略。研究结果表明，政府监管、患者认知和规范医疗行为的收益是影响政府监管下医患演化博弈系统的关键因素。通过调整不同策略选项的相对权重、增加对违法行为的处罚以及根据医生规范行医收入正常化医疗事故费用，可以减少医疗事故的发生。为了有效解决医疗事故问题，建议采取调整监管框架、合理确定医疗从业者违法行为和患者医疗事故行为监管力度、多样化监管方法、建立全面的医患管理系统以解决信息不对称问题等措施。

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