在公共医院成本控制中运行游戏理论权重:中国三级医院的实施框架
Zhihao Yu1, Guangning Sun2, Shuaijun Lin1
1Faculty of Humanities and Social Sciences, Macao Polytechnic University, Macao, China.
Cost effectiveness and resource allocation : C/E
|April 1, 2025
概括
本研究引入了基于游戏理论的框架,以改善公共医院的成本控制,减少主观偏见和预算超支. 新方法显著提高了成本管理效率和整体满意度.
科学领域:
- 医疗保健管理的管理
- 运营研究 运营研究
- 公共卫生政策 公共卫生政策
背景情况:
- 公共医院成本管理往往依赖于主观的管理判断,导致预算超支.
- 由于成本控制的系统性问题,中国东部的一家三级医院在2020年经历了12.9%的超支.
- 公共医院现有的成本控制策略往往缺乏强大,系统的方法.
研究的目的:
- 引入一种新的决策框架,使用游戏理论组合权重方法来管理医院成本.
- 通过将专家判断与客观数据协调,减轻成本控制中的主观偏见.
- 为公立医院提供更科学,更系统的成本管理方法.
主要方法:
- 使用文献审查和德尔菲方法建立了成本控制评估指数系统.
- 采用分析层次过程 (AHP) 和重法 (EWM) 来确定主观和客观的重量.
- 使用基于游戏理论的组合权重方法进行综合权重,并实施了为期三年的优化方案,通过模糊的综合评估进行评估.
主要成果:
- 重新校准指标权重,将重点从过度强调的领域 (工资,奖金) 转移到以前低估的领域 (物流供应,公用事业,处置阶段).
- 在三年内在人员,物资,药品,行政和资本支出方面取得了显著的改善.
- 将医院的整体满意度评分从79.5656提高到90.2492,在重量重点增加的地区获得的最大收益.
结论:
- 基于游戏理论的综合权重方法有效优化了公共医院的成本控制策略.
- 这种方法促进了在成本管理较弱的领域进行有针对性的干预,并减少了决策偏见.
- 提高了成本控制的严谨性,效率和系统性,支持医疗领域的决策.
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