Business School, Yunnan University of Finance and Economics, Kunming, China.
Yunnan Key Laboratory of Service Computing, Yunnan University of Finance and Economics, Kunming, China.
Front Public Health. 2024 Jan 5;11:1324228. doi: 10.3389/fpubh.2023.1324228. eCollection 2023.
The construction of medical consortiums not only promotes active cooperation among hospitals, but also further intensifies active competition among them. The shared use of electronic health records (EHR) breaks the original pattern of benefit distribution among hospitals.
The purpose of this paper is to establish an incentive mechanism for the shared use EHR, and to reveal the incentive effect and mechanism of key factors, and to put forward management suggestions for solving the real conflicts.
We constructed a basic incentive model and an incentive model that introduces performance evaluation as a supervisory signal, based on analyzing the hospital cost function, the hospital benefit function, and the incentive contract function. Finally, the incentive effects of key factors before and after the introduction of performance evaluation were verified and compared using MATLAB simulation method.
The profit level and incentive coefficient of hospitals sharing EHR are independent of the amount of one-time government subsidies. Regardless of whether a performance evaluation supervisory signal is introduced or not, the incentive coefficients are increasing functions with respect to ρ, τ, but decreasing functions with respect to β, δ, γ. After the inclusion of supervisory signal of performance evaluation in the model, the ability of hospitals to use EHR has a higher impact effectiveness on improving both incentive effects and benefit levels. The impact of the value-added coefficient on the level of earnings is consistently greater than it would have been without the inclusion of the performance evaluation supervisory signal.
Enhancing the capacity of hospitals to use EHR and tapping and expanding the value-added space of EHR are 2 key paths to promote sustainable shared use of EHR. Substantive performance evaluation plays an important role in stabilizing incentive effects.
医疗联合体的建设不仅促进了医院间的积极合作，而且进一步加剧了它们之间的积极竞争。电子健康记录（EHR）的共享打破了医院之间原有的利益分配格局。
本文旨在建立 EHR 共享的激励机制，揭示关键因素的激励效应和机制，并提出解决实际冲突的管理建议。
我们基于分析医院成本函数、医院收益函数和激励合同函数，构建了一个基本激励模型和一个引入绩效评估作为监督信号的激励模型。最后，使用 MATLAB 仿真方法验证和比较了引入绩效评估前后关键因素的激励效果。
EHR 共享医院的利润水平和激励系数与一次性政府补贴的数额无关。无论是否引入绩效评估监督信号，激励系数都是ρ、τ的增函数，β、δ、γ的减函数。在模型中纳入绩效评估监督信号后，医院使用 EHR 的能力对提高激励效果和收益水平具有更高的影响效果。增值系数对收益水平的影响始终大于不包括绩效评估监督信号时的影响。
增强医院使用 EHR 的能力和挖掘和扩大 EHR 的增值空间是促进 EHR 可持续共享的 2 条关键路径。实质性绩效评估对稳定激励效果起着重要作用。
