Multi-dimensional Value Analysis Of Healthcare Services And Research On The Allocation Of Medical Resources

In both developed and developing countries,healthcare service is an important social issue which is concerned by the government and the public,for it is directly related to the development of human being health.Over the past twenty years,healthcare service in China has made brilliant achievements with scientific and technological innovation,medical technology improvement and great leap of Chinese economy.Disease prevention and control ability strengthened unceasingly,health insurance coverage expanded step by step,and people's health level was significantly improved.From the world's point of view,Chinese medical system has been able to provide good service for people,however,there are still some problems to be solved.For example,marketization of medical industry causes a serious lack of public welfare in public hospitals,irrational allocation of medical resources leads patients clustering seriously in three A grade hospitals,and to see a doctor becomes more and more difficult and expensive.Facing with multiple challenges,such as environmental pollution,food safety,population growth and aging,Chinese healthcare reform still has a long way to go.This article analyzes healthcare system from a perspective of value,aimed at providing a new direction of healthcare reform.First,health value chain was constructed based on traditional value chain,participating subjects and activities which creating value were identified.Then the article qualitatively analyzed the value connotation and value orientation of healthcare service.Next,we quantitatively analyzed the value healthcare service.Based on expert interview and literature research,a multidimensional index system of healthcare value was constructed from four dimensions,and they are health benefits,economic benefits,public benefits and resource consumption.The index system took the practical operation into account,and all the indicators screened can be quantitatively described.To solve the problem of dimensional difference of different indicators,the concept of utility was applied.Then the value evaluation model was established from different angles of government,hospital and patient.Also,the model was proved to be feasible through a small case study.At last,based on health utility,a mixed-integer programming model which combines equity and utilitarianism was built to maximize social welfare.When the disparity of utility is small,equity is adopted.However,the objective becomes utilitarian once the disparity becomes great.The model was applied to hierarchical medical decision making.The result shows that equity criterion should be adopted to treat critical diseases,while medical resources are allotted to high level hospital,and that utilitarianism criterion should be adopted to treat mild diseases,while medical resources are allotted to low level hospital.In conclusion,this study builds the healthcare service evaluation model regarding value as the core.Compared with traditional evaluation system which purely pursuits economic benefits or healthcare service quality,this model weighs the interests of the hospitals,patients and governments,embodying the basic mission and public welfare of public hospitals.Thus,it can help to change the way that hospitals operate mainly for making profits.The mixed integer programming model based on the health utility combines equity and utilitarianism when allocate medical resources,which has very positive theoretical significance on health policies making.