考虑双重信息不对称及互动二元性的医患信任机制

Evolutionary Game of Doctor-patient Trust Considering Dual Information Asymmetry and Interaction Duality

摘要:

从医患双方出发，考虑信任关系建立中医患互动的二元性，构建双重信息不对称下逆向选择与道德风险同时存在的医患信任演化博弈模型。通过模型求解和仿真模拟，分析各因素对医患信任的影响。结果表明，医患双方对彼此的期望高于实际能力并不总是导致负面情绪，在期望高于实际但不超过临界值的情况下，合理的高期望有助于双方信任策略演化；在确保患方信息受益的情况下，即使相对医方存在信息劣势，医患双方依旧倾向于信任策略；提高医方沟通能力、降低患者道德风险对信任策略选择更为关键。最后，结合1·20北京朝阳医院伤医案事件，讨论了医患沟通、期望及道德风险等因素对医患双方信任行为的演化结果，论证了模型的有效性。

Abstract:

Considering the duality of doctor-patient interactions from both sides， an evolutionary game model of the doctor-patient trust with the simultaneous existence of adverse selection and moral hazard under the dual information asymmetry was constructed. The effect of factors on the doctor-patient trust was analyzed through the evolutionary equilibrium solution and simulation. It is shown that， the expectation higher than actual ability does not always result in negative emotion， and the reasonably high expectation helps both sides evolve their trust strategy when the expectation is higher than the actual condition but does not exceed the critical value； when it comes to ensure the patient’s information benefit， even there is an information disadvantage compared to the doctor， both doctors and patients still prefer trust strategy； it is more critical to improve the communication ability of the doctor and reduce the moral risk of the patient for trust strategy selection. Finally， in the context of the 1·20 Beijing Chaoyang Hospital injury case， the effects of the discussed progression of doctor-patient communication， expectation， and moral hazard on the trust behavior of both doctors and patients were discussed， and the effectiveness of the model was verified.