面向慢性病的在线医疗医患互惠机制及服务模式研究

The aggravation of the aged social phenomenon in our country makes the group of chronic patients become more and more large. Online health services provide more convenient, efficient and low-cost diagnosis and treatment for patients with chronic diseases. How to attract doctors and patients to actively participate in online medical services remains to be solved. First of all, this project starts with the bilateral market attributes of the online medical service platform, and analyzes its market characteristics and interaction mechanism for both doctors and patients. Secondly, it is oriented to the online service of chronic disease, and makes an empirical analysis on the decision driving factors of the participation of both doctors and patients, and quantifies the importance of the factors. Thirdly, we use expert interviews, questionnaires and behavioral experiments to explore mutually beneficial service models that are helpful for doctors, patients and platforms to achieve the maximum utility of all parties. Finally, the effectiveness of online medical service on health status transformation of chronic disease patients is tested, and the effectiveness is evaluated from the aspects of patient health management strategy and actual health status transformation. The findings will help to identify the market mechanism of online medical services and the mechanism of their impact on individual health，leading patients, doctors and platforms to actively participate in online medical services. Research findings will also exert positive influences on improving the current situation of the medical resources shortage and the imbalance of development, and improve the efficiency of service.

我国老龄化社会等问题的加剧使得慢性病人群日益庞大。在线医疗服务为慢性病患者提供了更为便捷、高效和低成本的诊疗方式，但如何吸引医患双方积极参与有待解决。本项目从在线医疗服务平台的双边市场属性入手，分析其面向医患双方的市场特征及交互机制；然后面向慢性病在线服务，对医患双方参与行为的决策驱动因素进行实证分析，量化各要素的重要性；而后利用专家访谈、问卷调查及行为实验等方式探索设计有助于医生、患者及平台等多方接受的互惠服务模式，以期达到各方的效用最大化；最后对在线医疗服务对慢性病患者健康状态转化的效用进行检验，从患者健康管理策略和实际健康状态转化等方面对有效性进行评价。研究结果将有助于明确在线医疗服务的市场机制及其对个人健康影响的作用机制，引导慢病患者、医生及平台各方积极参与在线医疗服务，进一步发挥在线医疗的力量，以改善就医资源紧张及发展不平衡的现状，提高服务效率。

在线医疗服务为慢性病患者提供了更为便捷、高效和低成本的诊疗方式，但如何吸引医患双方积极参与有待解决。本项目从在线医疗服务平台的双边市场属性入手，分析了在线医疗平台的市场特征：1）具有平台用户即患者数和医生数受对方影响的交叉网络外部性；2）医生和患者的需求互补性；3）多平台接入特点；4）具有价格弹性可形成价格歧视，明确了在线医疗平台的用户交互机制。然后面向慢性病在线服务，对医患双方参与行为的决策驱动因素进行分析，利用抓取的慢病患者在线问诊数据、线下的患者、医生调研访谈数据等进行实证分析，量化各要素的重要性，发现在线诊疗方式的有效性、对医生的信任程度、技术因素和费用认可程度和疾病种类等是阻碍慢病患者使用在线平台的主要因素，而线下工作繁忙、职称晋升压力、业绩考核方式和经济收益等是阻碍医生提供在线诊疗服务的压力来源。通过对医患双方的需求及冲突痛点进行匹配，发现鼓励慢病患者进行线上复诊等健康管理方式是可同时满足医患双方需求的有效途径之一，但需要来自医患双方、医院和服务平台等多方面的共同努力及政策制定等，互惠服务模式有待进一步探究。新兴的游戏化在线健康应用及服务机制对慢病患者的健康状态转化具有积极作用。项目研究结果有助于明确在线医疗服务的市场机制及其对个人健康影响的作用机制，引导慢病患者、医生及平台各方积极参与在线医疗服务，进一步发挥在线医疗的力量，以改善就医资源紧张及发展不平衡的现状，提高服务效率。