Evolutionary Game Theory On Over-treatment Behavior Under Drug-proportion Regulation

Drug-proportion regulation is on implementing following the price regulation and the elimination of markups on pharmaceuticals to curb the over-treatment,which is an important issue for Chinese healthcare reform.Based on that,we establish an evolutionary game model of physician-patient behavior under drug-proportion regulation.Theoretically,it founds that there exists behavioral evolutionary law and stable strategies between physicians and patients according to replicator dynamics equation.The factors,such as normal treatment costs,increased rate of over-treatment costs,the coefficient of physicians’ performance,and the severity of illness are considered when analyzing the choice of physicians’ treatment strategies.Further,the reputation punishment mechanism are introduced under the over-treatment situation.The behavior choice of physicians and patients are obtained under the reputation punishment mechanism.The factors,such as punishment of reputation,knowledge level of patients and information quality are discussed when analyzing the choice of physicians’ treatment strategies.The results show that:(1)Drug-proportion regulation does not always inhibit over-treatment,which depends on a transition point.Physicians choose overtreatment,when the drug-proportion is lower than the transition point.(2)The higher the normal treatment costs,the greater the increased rate of over-treatment costs,the smaller the coefficient of physicians’ performance,the lower the reward and punishment of drug-proportion,then the greater the probability that physicians will choose normal treatment.Particularly,the severity of illness affects over-treatment,under the drug-proportion regulation.Physicians tend to choose over-treatment when patients are less ill.(3)In the medical service market,when the reputation punishment is large enough,it can effectively inhibit the physicians’ over-treatment behavior.At the same time,enhancing the patients’ knowledge level and improving the quality of medical information are conducive to promoting physicians’ normal treatment.Finally,based on the research conclusions,suggestions are given for the setting of drug-proportion,key monitoring of light illness,hierarchical diagnosis,information disclosure mechanism,establishing reputation market and supervising information quality to curb over-treatment and reduce patient medical expenses.