Study On The Optimal Decision-Making Of Designated Hospital Selection And Reimbursement Proportion Based On Budget

Using tax revenues to subsidize health insurance and to achieve safe and effective health services have become an important means of health care reform for governments.However,in the reform of health care policy,it is still a challenge that the governments of some countries must face to select designated hospitals or specific medical facilities and how to determine the reimbursement ratio to maximize the total social welfare of patients and hospitals.In this paper,there are government,a tertiary hospital,a community hospital and patients in the medical system.We try to address the problem by constructing a sequential three-stage game model consisting of the government to determine the designated hospitals and reimbursement ratio,hospitals determining the service price and patients selecting a hospital.The target is to maximize the total social welfare to provide evidence for the government to make the optimal decisions.In view of the fact that the government often needs to take into account the budget constraints when making decisions.Therefore,in this paper,we study the government's best decision from two aspects:the budget given and the minimum budget.In the budget given,there are price competition in the tertiary hospital and the community hospital.The main conclusions are as follows:(1)more designated hospitals approved by the government may not guarantee that the greatest social total welfare,which also considers the reimbursement ratio and cost gap.When making decisions,we cannot blindly increase the reimbursement ratio,which is not conducive to the realization of the target;(2)the increase in the largest patient's valuation in community hospitals and the differences in medical services also contribute to an increase in the total social welfare,in other words,the greater the perceived preference for patients,the greater the preference for government goals;(3)Increasing the reimbursement ratio of the tertiary hospital in providing reimbursement ratio to both hospitals will help to improve the competitiveness of the scenario;(4)The total social welfare increases as the medical budget increases.Under the minimum budget,it is assumed that the reimbursement ratio of the community hospital is either 1 or 0,and the service price is equal to the cost.The main conclusions are:(1)when the financial input is equal to the minimum reimbursement cost,the change of the cost gap is more likely to affect the change of the government's optimal decision-making.(2)When the financial input is greater than the minimum reimbursement cost,compared with the case when the financial input is equal to the minimum cost,in addition to the difference in medical service and the largest patient's valuation in community hospitals will have an effect on the optimal decisions in the case that the financial input is larger.