Study on the evolutionary strategy of upward patient transfer in the loose medical consortia

Jialing Li; Guiju Zhu; Xinya Hu; Ruqian Fei; Dan Yu; Dong Wang; Jialing Li; Guiju Zhu; Xinya Hu; Ruqian Fei; Dan Yu; Dong Wang

doi:10.3934/mbe.2023751

Mathematical Biosciences and Engineering

2023, Volume 20, Issue 9: 16846-16865. doi: 10.3934/mbe.2023751

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Study on the evolutionary strategy of upward patient transfer in the loose medical consortia

Jialing Li ¹,
Guiju Zhu ¹,
Xinya Hu ¹,
Ruqian Fei ^{2
,
,},
Dan Yu ^{2
,
,},
Dong Wang ²

1.
School of Management, Hunan University of Technology and Business, No. 569 Yuelu Avenue, Changsha, China
2.
Xiangya Hospital, Central South University, Changsha, China

Academic Editor: Carlo BIANCA

Received: 04 July 2023 Revised: 09 August 2023 Accepted: 14 August 2023 Published: 24 August 2023

Medical institutions in loose medical consortia tend to have poor cooperation due to fragmented interests. We aim to explore any issues associated with patient upward transfer in a loose medical consortium system consisting of two tertiary hospitals with both cooperative and competitive relationships. A two-sided evolutionary game model was constructed to assess the stability of equilibrium strategy combinations in the process of interaction between game players under different cost-sharing scenarios and different degrees of penalties when running patient upward transfer between super triple-A hospitals (STH) and general triple-A hospitals (GTH). We found that a hospital's stabilization strategy was related to its revenue status. When a hospital has high/low revenues, it will treat patients negatively/positively, regardless of the strategy chosen by the other hospital. When the hospital has a medium revenue, the strategy choice will be related to the delay cost, delay cost sharing coefficient, government penalty and the strategic choice of the other hospital. Delay cost-sharing coefficient is an important internal factor affecting the cooperation in a medical consortium for patient upward transfer. External interventions, such as government penalty mechanisms, can improve the cooperation between hospitals when hospitals have moderate revenue.
- loose medical consortia,
- evolutionary game,
- triple-A hospital,
- delay cost
Citation: Jialing Li, Guiju Zhu, Xinya Hu, Ruqian Fei, Dan Yu, Dong Wang. Study on the evolutionary strategy of upward patient transfer in the loose medical consortia[J]. Mathematical Biosciences and Engineering, 2023, 20(9): 16846-16865. doi: 10.3934/mbe.2023751

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Abstract

Medical institutions in loose medical consortia tend to have poor cooperation due to fragmented interests. We aim to explore any issues associated with patient upward transfer in a loose medical consortium system consisting of two tertiary hospitals with both cooperative and competitive relationships. A two-sided evolutionary game model was constructed to assess the stability of equilibrium strategy combinations in the process of interaction between game players under different cost-sharing scenarios and different degrees of penalties when running patient upward transfer between super triple-A hospitals (STH) and general triple-A hospitals (GTH). We found that a hospital's stabilization strategy was related to its revenue status. When a hospital has high/low revenues, it will treat patients negatively/positively, regardless of the strategy chosen by the other hospital. When the hospital has a medium revenue, the strategy choice will be related to the delay cost, delay cost sharing coefficient, government penalty and the strategic choice of the other hospital. Delay cost-sharing coefficient is an important internal factor affecting the cooperation in a medical consortium for patient upward transfer. External interventions, such as government penalty mechanisms, can improve the cooperation between hospitals when hospitals have moderate revenue.

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