Analysis on the rush point behavior of medical institutions under the total budget of regional point method ——Take DIP payment method as an example

Corresponding author: XIANG Li, xllyf@126.com

DOI: 10.12201/bmr.202207.00022

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  Abstract: As a budget control method, the total budget of regional point method can be combined with different payment methods. Exploring the punching point behavior of medical institutions under the total budget of regional point method will help to improve the operation mode of medical insurance payment. This study combs the rush point behavior of medical institutions under the total budget of the regional point method, and uses game theory to reveal the rush point behavior choice of medical institutions under the dip payment method. Both theory and practice have proved that the total budget of regional point method will bring about the risk of rush point behavior of medical institutions. According to the game model, the strict advantage strategy of dip payment is all kinds of rush point behaviors including unreasonable medical treatment. The amount of punishment for unreasonable rush point behavior, the supervision cost of medical insurance agencies, and the amount of additional income from unreasonable rush point behavior have an impact on the unreasonable rush point behavior of medical institutions and the degree of supervision of medical insurance agencies. The medical insurance department needs to optimize the payment, supervision mechanism and other implementation modes to reduce unreasonable rush point behavior.

  Key words: DIP; Rush point behavior; Total budget of regional point method; Medical insurance payment method

  Submit time: 11 July 2022

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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• ID	Submit time	Number	Download
  1	2022-04-12	10.12201/bmr.202207.00022V1	Download

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