Abstract: In recent years, the continuous growth of the global population and the intensification of the aging trend have increased the demand for medical resources. The emergence of new diseases and the increasing burden of chronic diseases have further challenged the medical system. To address these issues, countries have been promoting healthcare reform policies aimed at improving the quality and efficiency of medical services, ultimately safeguarding the health rights of citizens. A key aspect of this reform is the sharing of medical information, which is considered to improve the efficiency of resource utilization and reduce the imbalance in resource allocation.
Medical information sharing includes electronic medical records, inter-institutional information exchange and medical research data sharing. A unified platform facilitates information exchange across regions and institutions, enabling medical staff to access comprehensive and timely patient health information, thereby improving the accuracy of diagnosis and treatment. In addition, medical information sharing also helps to optimize the allocation of medical resources. By analyzing medical data nationwide, it is possible to better understand the distribution of diseases and medical needs in various regions, thereby allocating medical resources more rationally, improving the efficiency of resource utilization, and alleviating the problems caused by the imbalance of medical resources between regions.
However, due to concerns about privacy breaches and potential revenue losses for hospitals, hospitals and patients show limited enthusiasm for medical information sharing. To address this issue, we have constructed a multi-stage duopoly dynamic game model to explore the factors influencing the participation of hospitals and patients in information sharing. Given two competing public hospitals, A and B, patient decisions are influenced by the perceived net utility of service quality, price and travel costs. Although service prices are set by social planners, hospitals decide on service qualities to maximize their own payoffs.
Our study analyzes the service quality decisions of hospitals at multiple patient care stages, considering multi-stage treatment. At the same time, it examines the impact of information sharing on hospital decision-making, benefits and social welfare, exploring the dynamic strategic evolution of hospitals in information sharing. Key findings include: First, health examination costs significantly influence hospital decisions. Lower costs or higher marginal service costs increase the hospital’s inclination towards information sharing, indicating that reducing health examination costs can foster a more conducive economic environment for sharing. Service quality decisions depend on specific circumstances. When marginal service costs are low, hospitals participating in information sharing set higher service quality in the first stage than under non-sharing scenarios. Second, for patients not transferred in the second stage, information sharing is more likely to bring about higher service quality, while for transferred patients, not sharing is more likely to bring about higher quality. This emphasizes the complex relationship between service quality and information sharing strategies. Additionally, comparing the benefits of hospitals and social planners with and without information sharing shows that when hospitals share information, social planners tend to set higher service prices, potentially compensating hospitals for revenue losses. However, excessively high prices may dampen patient enthusiasm for sharing, hindering its development. Therefore, while ensuring the economic benefits of hospitals, it is also necessary to consider the interests of patients and find a balance. Moreover, the study shows that when marginal service costs are low or health examination fees are not too high, both social planners and hospitals are inclined to medical information sharing, at which point the interests between social planners and hospitals can be aligned.
In conclusion, medical information sharing is crucial for improving resource utilization and mitigating allocation disparities. However, limited enthusiasm from hospitals and patients hinders its progress. By understanding hospitals’ and patients’ decision-making mechanisms through a dynamic game model, social planners can implement incentive measures, fostering greater hospital cooperation to advance medical information sharing.

Key words: medical information sharing, service quality competition, service quality differentiation

摘要： 医疗机构间合理的信息共享是提高医疗资源利用率、缓解资源分配不均的重要途径。然而,医院和患者参与医疗信息共享的积极性不足,使得共享进程发展缓慢。本研究旨在探究服务质量差异化情形下医疗机构间医疗信息共享的动机。考虑两家竞争性公立医院,采用Hotelling模型构建患者进行医院就诊决策的效用函数,进一步构建了两阶段双寡头动态博弈模型。从患者两时期就诊的角度出发,考虑了医院在两个就诊阶段针对不同患者服务质量的差异化决策,分析了健康检查费用对医院服务质量决策和社会规划者价格决策的影响,并对有无医疗信息共享情境下医院及社会规划者的收益进行对比。研究结果表明,社会规划者在医院医疗信息共享时倾向提高服务价格,医院则在健康检查费用低或边际服务成本高时,会调整服务质量以优化收益。在特定条件下社会规划者与医院间利益可以达成一致,均更倾向于医疗信息共享。

关键词: 医疗信息共享, 服务质量竞争, 服务质量差异化