Research Of Public Hospital Compensation Based On The Game Between Stakeholders

Background: In China, public hospitals are the main institutions in health care system. As a universal common nonprofit public benefit, public hospitals establish a bond of cooperation for itself and other stakeholders. The management objectives of public hospitals are impact by the result of game between various stakeholders. However, because the interests orientations and game strategy of the various stakeholders are different, China’s public hospitals cannot perform their public service well, the phenomenon of "Difficulty and high cost to access medical service" become a growing problem.Objective: By investigating and analyzing the basic situation of public hospitals compensation in Ningxia. Use stakeholder theory and game theory to analyze the situation of compensation stakeholders. Looking for the suitable financial operation mechanisms that can perform the public service. Build the sample county public hospital totally compensated by the government, compensated by medical insurance transfer payment and compensated by both government and medical insurance transfer payment. And explore more cost-effective and reasonable public hospital compensation model. Provide policy recommendations for government in public hospitals reform.Methods: Select the Yanchi County People’s Hospital, Helan County People’s Hospital and Yongning County People’s Hospital as sample hospitals. Use literature review, in-depth interviews, brainstorming and quantitative questionnaire as data collection methods. Use literature review analysis, Multi-dimensional subdivision analysis, game equilibrium analysis, descriptive analysis, and hospital cost estimation as data analysis methods.Result:The government’s financial investment and medical insurance transfer payment are increased year by year as main means of compensation for public hospitals. The government’s financial investment form the majority of all the compensation for public hospitals, and it is still hard to meet the needs of hospitals. The compensation from hospital service charges is ineffective.Six public hospital compensation models are built and measured based on the circumstance of the main stakeholders of public hospital like government, medical insurance organizations, patients and hospital. In compensation model one, public hospital compensation all comes from government. Three samples invested 526,600,000 yuan, 47,260,900 yuan and 71,080,000 yuan respectively by government to ensure public hospital maintain their status and provide free or cheap medical services. And that help government to manage the public hospital well. Hospital can establish a good social image and control medical costs, ensure the fairness and accessibility of universal health care.In compensation model two, medical insurance transfer payment is the main means of compensation for public hospitals. Three samples invested 526,600,000 yuan, 47,260,900 yuan and 71,080,000 yuan respectively by medical insurance transfer payment to ensure public hospital maintain their status and format scientific medical insurance mechanism,help medical insurance department to manage the public hospital well, improve the efficiency of health workers.In compensation model three, government compensate for hospital costs and medical insurance transfer payments to compensate for other parts. In Yanchi County people’s hospital, government compensates 39,596,300 yuan and medical insurance transfer payment compensates 13,063,700 yuan.In Helan County people’s hospital, government compensates 39,126,600 yuan and medical insurance transfer payment compensates 8,134,300 yuan.In Yongning County people’s hospital government compensates 60,431,700 yuan and medical insurance transfer payment compensates10,648,300 yuan.And this can ensure the normal operation of the hospital, improve efficiency and control hospital costs.In compensation model four, government compensates for the universal health care service and medical insurance transfer payments to compensate for other parts. In Yanchi County people’s hospital, government compensates 7,903,500 yuan and medical insurance transfer payment compensates 44,756,500 yuan.In Helan County people’s hospital, government compensates 9,607,900 yuan and medical insurance transfer payment compensates 37,653,000 yuan.In Yongning County people’s hospital government compensates 4,280,200 yuan and medical insurance transfer payment compensates 66,799,800 yuan. And this ensure the functional orientation of county public hospital, promoting achieve the goal of universal access to basic health care.In compensation model five, taking the influence of factors such as released demand,price index into account,government compensate for hospital costs and medical insurance transfer payments to compensate for other parts. In Yanchi County people’s hospital, government compensates 47,302,900 yuan and medical insurance transfer payment compensates 15,608,300 yuan.In Helan County people’s hospital, government compensates 57,165,000 yuan and medical insurance transfer payment compensates 11,883,200 yuan.In Yongning County people’s hospital government compensates 81,401,600 yuan and medical insurance transfer payment compensates 14,342,500 yuan. And this ensures the normal operation of the hospital, providing a more reasonable compensation model based on compensation model three.In compensation model six, taking the influence of factors such as released demand,price index into account,government compensate for the universal health care service and medical insurance transfer payments to compensate for other parts. In Yanchi County people’s hospital, government compensates 9,943,000 yuan and medical insurance transfer payment compensates 53,468,200 yuan.In Helan County people’s hospital, government compensates 14,037,500 yuan and medical insurance transfer payment compensates 55,010,700 yuan.In Yongning County people’s hospital government compensates 5,763,800 yuan and medical insurance transfer payment compensates 89,980,300 yuan. And this ensures the normal operation of the hospital, providing a more reasonable compensation model based on compensation model four.Recommendation:1.Build a proper value system is the fundamental way to solve the compensation of public hospitals and other social issues.2. Increase the level of government investment, to perform their public service.3. Defining the connotation of public hospital, improve the level and the mode of government compensation, establish and improve standards of compensation.4. Calculate the cost of medical services and made a reasonable price for medical services.5. Strengthen the internal manage to control hospital costs.6. 6.Implement the new compensation model based on the situation of public hospital stakeholders.