Game Analysis of the Excessive Expansion of Hospital Service Volume of Medical Institutions Under the DIP Payment Method&#x02014;&#x02014;Based on the Stakeholder Theory

doi:10.19546/j.issn.1674-3830.2025.5.004

China Health Insurance ›› 2025, Vol. 0 ›› Issue (5) : 26-32. DOI: 10.19546/j.issn.1674-3830.2025.5.004

Game Analysis of the Excessive Expansion of Hospital Service Volume of Medical Institutions Under the DIP Payment Method——Based on the Stakeholder Theory

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Abstract

Objective: The paper explores the causes and potential risks of excessive expansion of hospital service volume under the DIP reform, to provide references for optimizing the medical insurance payment system reform. Methods: Based on the stakeholder theory, a game model among medical institutions, medical insurance institutions, and patients under the DIP payment method was constructed. The equilibrium solutions were calculated to reveal the strategy choices and behavioral conflicts of each subject under different constraints. Results: Medical institutions can significantly influence patients' medical choices. medical institutions have the motivation and willingness to adopt excessive expansion of service volume strategies under the DIP payment method, and strict supervision by medical insurance institutions can reduce the probability of unreasonable excessive expansion of service volume. Conclusion: By establishing an information disclosure mechanism, implementing the medical alliance and hierarchical medical treatment system, and improving the medical insurance supervision mechanism, a positive interaction among the three parties in the game can be formed to ensure the sustainable and healthy operation of medical insurance funds.

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DIP / excessive expansion of service volume / stakeholder / game

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Game Analysis of the Excessive Expansion of Hospital Service Volume of Medical Institutions Under the DIP Payment Method——Based on the Stakeholder Theory[J]. China Health Insurance. 2025, 0(5): 26-32 https://doi.org/10.19546/j.issn.1674-3830.2025.5.004

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