中国卫生资源
中國衛生資源
중국위생자원
CHINESE HEALTH RESOURCES
2014年
2期
135-137
,共3页
商业健康保险%医疗机构%过度医疗%供方欺诈%纳什均衡
商業健康保險%醫療機構%過度醫療%供方欺詐%納什均衡
상업건강보험%의료궤구%과도의료%공방기사%납십균형
commercial health insurance%medical institutions%excessive diagnosis and treatment%supplier fraud%Nash equilibrium
为促进我国健康保险市场的平稳发展,对医疗机构与健康保险公司之间的博弈关系进行了分析,结合当前实际,建议政府应当大力推进相关制度基础设施建设,这包括协助建立医疗机构-保险公司信息共享平台、推进医药分家制和费用预付制以及加大对违规医疗机构人员的执法力度等。
為促進我國健康保險市場的平穩髮展,對醫療機構與健康保險公司之間的博弈關繫進行瞭分析,結閤噹前實際,建議政府應噹大力推進相關製度基礎設施建設,這包括協助建立醫療機構-保險公司信息共享平檯、推進醫藥分傢製和費用預付製以及加大對違規醫療機構人員的執法力度等。
위촉진아국건강보험시장적평은발전,대의료궤구여건강보험공사지간적박혁관계진행료분석,결합당전실제,건의정부응당대력추진상관제도기출설시건설,저포괄협조건립의료궤구-보험공사신식공향평태、추진의약분가제화비용예부제이급가대대위규의료궤구인원적집법력도등。
A game-theoretic analysis of the interaction between medical institutions and health insurance companies was conducted to promote the development of the health insurance business. Several institutional infrastructure were proposed to be constructed,including the construction of information sharing platform between medical institutions and insurance companies,the separation of medical service and pharmaceutical sales together with the spread of the prepaid system,and the strengthening of the law enforcement against the fraud.