Research On Influencing Factors And Incentive Policies Of Medical Information Sharing

Implementing medical information sharing among hospitals can alleviate the social problems of “difficulties and high expense in medical care” and promote the effective use of medical resources.At the same time,it is a necessary basis for medical reforms and an inevitable requirement for the modernization of medical services.In recent years,the Chinese government has been promoting medical information sharing among hospitals.However,hospitals do not spontaneously participate in the information sharing process in consideration of their own benefits,costs,and risks.To deal with this problem,we carried out our study in three aspects of information sharing among hospitals: the influencing factors,the evolution process,and the incentive mechanism.Firstly,based on the characteristics of medical institutions in China and the current status of medical information sharing,we conduct an empirical study of the influencing factors of information sharing among hospitals.Through literature review and serval semi-structed interview,we summed up 5 kinds of factors.Followed by a scenario-based experiment,we find that the increase of external force,hospitals' benefit-risk ratio and recognition can significantly promote information sharing between hospitals.Afterwards,we analyzed the evolution process and equilibrium results of hospital group participate in information sharing under the government's policy.Based on the information sharing process of the Medical Consortium in China,we introduced the Metcalfe's law and patients' supervision,the interests of the governments and hospitals are analyzed.An evolutionary game model between hospitals and governments is established and the equilibrium state under different conditions are studied by solving the replicator dynamic equations.The results showed that reducing the risk cost of information sharing,standardizing and improving the quality of information sharing in the hospital,encouraging patients to supervise hospitals behavior of information sharing,making attractive reward and proper punishment policy are the key factors to promote the medical information sharing.The results can provide a reference for governments to evaluate the information sharing trend of the hospital and to establish incentive and punishment mechanism to stimulate medical information sharing.Finally,we studied how to design the most effective incentive mechanism for different hospitals.We constructed a multi-stage healthcare information-sharing incentive model with consider of symmetric and asymmetric information backgrounds,and risk neutral and risk aversion hospitals.The modeling progress is based on principal-agent theory in consideration of the features of the Medical Consortium,and in which we proposed the concepts of information “complementarity” and “usability” to measure the using and sharing behaviors of the hospital.The results showed that when the regulatory authorities have asymmetric information of the risk averse hospitals' sharing efforts,the optimal incentive coefficient has a positive correlation with the information inventory,the information complementarity or usability as well as the expected benefits of unit information,but has a negative correlation with the hospitals' cost coefficient,the risk cost factor,risk aversion ratio and variance of random factors.