Research On Sustainable Operation Decision Of City Medical Association Information Platform Based On Subscription Plan

With the promotion of medical information technology and the development of market-oriented reform,different types of city medical associations have problems to maintain sustainable operation without the extensive subsidies of government agencies.In order to solve the problems and provide direction for government agencies to implement subsidy policy lean and platform supervision,the optimization theory is used to establish MINLP models for maximizing the revenue of city medical association information platform operator.The costs and benefits of city medical association from the perspectives of information platform operator,tertiary hospitals,and community hospitals are quantified.The probability of patients participating the community hospitals and the allocation of value-added diagnosis are considered.The subscription plans are designed for loose city medical association and semi-compact city medical association,based on which to decide whether the hospitals participate in the information sharing and their suitable subscription plans.The hospital only has the willingness to share information if the income after participating is greater than or equal to the fee paid to the platform.The meta-heuristic algorithm is used to obtain the optimal pricing strategy of subscription plans with the objective to maximize the platform operator's benefit.Through the sensitivity analysis,the research shows that the subscription plans: paying annually and paying per visit in loose city medical association,as well as the subscription plans: paying annually and paying per service which combine the distribution mechanism of value-added business in semi-compact city medical association and the platform operators to optimize the subscription plan rate can achieve the sustainable operation.Tertiary hospitals prefer paying per visit and community hospitals prefer paying annually in loose city medical association,community hospitals prefer paying per service and tertiary hospitals have no tendentiousness for subscription plans in semi-compact city medical association.Lower the basic inspection and quarantine payment price,increase the avoid readmission rate can improve hospitals participate and platform operator revenue in loose city medical association,simultaneously.Regulate the price of value-added medical service can promote the willingness of community hospitals and platform operator revenue in semi-compact city medical association.Increase the revenue distribute proportion of tertiary hospitals in the remote diagnosis service can significantly increase the revenue of platform operator,but significantly reduce the willingness of community hospitals to participate.Meanwhile,the proportion of platform operator in value-added service will reduce the sustainability of semi-compact city medical association.Therefore,government agencies should formulate corresponding subsidy regulation and control strategies for the operation of city medical associations in different scenarios: in the loose city medical associations,basic inspection service in community hospitals and tertiary hospital medical facilities should be subsidized;In the semi-compact medical association,the value-added remote diagnosis service of tertiary hospitals should be subsidized.At the same time,the proportion of revenue distribute between hospitals and the proportion of platform operator in value-added service developed by the platform operator should be supervised,which will be beneficial to the sustainable operation of city medical associations.