Research On Quality Incentives And Collaboration Of Medical Service Supply Chain Under The Mode Of Health Alliance

Factors such as the development of social life and changes in population structure have contributed to rapid increase in demand for medical services in China.The issue of how to provide high-quality,high-efficiency and high-access medical services has attached much attention.To promote the efficiency of medical resources utilization,the Chinese government has carried out the policy of health alliance.Due to the complexity of cooperation,asymmetric information and differences between participants’ interest goals,many problems occurred.First,the quality of services is difficult to guarantee as the asymmetry information between the medical institutions in cooperation.Second,the unequal power structure leads to the fairness concerns of the partners and slackness during the service interaction.Third,the lack of external coordination mechanisms between the government and the health alliance causes poor performance.Under this background,analyzing the cooperative relationship of the participants in health alliance based on service supply chain management is important,as well as developing internal service quality incentive mechanisms in and out of the health alliance.This paper aims at the practical problems such as the mismatch between the supply and demand of medical resources,the insufficient quality management of medical services,and the insufficient cooperation between the government and the health alliance.To strengthen the internal cooperation and achieve external coordination of the health alliance,this paper builds the operation mode of the medical service supply chain based on current practices of health alliance in China and analyzes the multiple principal-agent relationships between the participants.Focusing on the kernel of the medical service supply chain(the cooperation between general hospitals and community medical center)and the principal-agent relationship,we study the design of service quality incentive mechanism between medical institutions and the quality coordination between government and medical service supply chain utilizing game theory,mechanism design,optimization techniques and other methods.First,we establish an incentive model to help the general hospital to ensure the community medical center to report real information and to guarantee the quality of service.The transfer payment contract is proven to avoid the adverse selection and moral hazard of the medical service supply chain,when service quality and/or capacity of the community medical center is private information.Secondly,on the basis of the community medical center’s appropriate service capability,we consider its limited voice in the health alliance and develop an incentive model considering its fairness concerned behavior,as well as obtain the optimal decision of unilateral and bilateral efforts in service cooperation.Finally,under the premise of establishing a stable quality incentive relationship between the general hospital and the community medical center,we develop a quality coordination model between the government and the medical service supply chain based on three-party evolutionary game theory.And we also explain the relationship between government policy factors and service homogenization management of medical institutions.Combining with the characteristics analysis and numerical experiments of the incentive contracts,this paper gives the optimal incentive contracts which can be adopted general hospitals to identify primary medical institutions with different service capabilities and to avoid moral hazard problems,as well as deal with the case when the primary medical institution is fairness concerned.Also,this paper reveals the synergistic relationship between the government policy factors,the behavior of medical institutions and service quality management.This research expands the application scope of service supply chain management and contract design theory in the field of medical services.But also,it provides theoretical basis for the quality management of medical services under the participation of multiple participants.And it provides many insightful ideas for governments and medical service institutions in health alliance management practice.