Gong Hanxiang, Zhang Tao, Wang Xi, Wu Baoling, Zhao Shufang
Faculty of Humanities and Social Sciences, Macau Polytechnic University, Macao, Macao SAR, China.
The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou City, Guangdong Province, China.
Front Public Health. 2025 Jul 17;13:1593398. doi: 10.3389/fpubh.2025.1593398. eCollection 2025.
Although China has made some progress in regulating and governing overtreatment behaviors in healthcare institutions, excessive medical care remains a persistent challenge in the Chinese healthcare sector.
This study adopts a perspective of bounded rationality and employs evolutionary game theory to construct a collaborative governance model involving government regulatory departments, healthcare institutions, and patients. The model analyzes the strategic stability of each participant and examines the impact of various factors, such as fiscal subsidies, government fines, rectification costs, regulatory costs, reasonable treatment income, and overtreatment income, on the strategic choices of the game participants. Parameter sensitivity within the three-party gaming system is also investigated through simulation analysis.
The findings indicate that when patients trust treatment outcomes and healthcare institutions are more inclined to provide appropriate care, government regulatory departments tend to adopt a more relaxed regulatory strategy. Simulation results show that increasing government fiscal subsidies, raising reasonable treatment income, and strengthening supervision and rectification efforts are effective in reducing overtreatment behaviors.
The decision-making of government regulatory departments is influenced by the degree of patient trust. Improving collaborative governance for overtreatment requires establishing comprehensive laws and regulations, leveraging government regulatory functions, strengthening internal constraint mechanisms in healthcare institutions, and raising patients' awareness of their rights and supervisory responsibilities.
尽管中国在规范和治理医疗机构的过度医疗行为方面取得了一些进展，但过度医疗仍是中国医疗行业持续面临的挑战。
本研究采用有限理性视角，运用演化博弈理论构建了一个包含政府监管部门、医疗机构和患者的协同治理模型。该模型分析了各参与者的战略稳定性，并考察了财政补贴、政府罚款、整改成本、监管成本、合理治疗收入和过度治疗收入等各种因素对博弈参与者战略选择的影响。还通过仿真分析研究了三方博弈系统内的参数敏感性。
研究结果表明，当患者信任治疗结果且医疗机构更倾向于提供适当治疗时，政府监管部门倾向于采取更宽松的监管策略。仿真结果表明，增加政府财政补贴、提高合理治疗收入以及加强监督整改力度，对于减少过度医疗行为是有效的。
政府监管部门的决策受患者信任程度的影响。改善过度医疗的协同治理需要建立全面的法律法规，发挥政府监管职能，加强医疗机构内部约束机制，并提高患者的权利意识和监督责任意识。
