Optimal Design of the Two-Tier Healthcare Systems with Internet Diagnosis Platform

In view of the current imbalance in the utilization of medical resources in the two-tier healthcare system, this study investigates the determination of referral thresholds for city hospitals and the optimal payment pricing for community hospitals in a system with an Internet diagnosis platform. We construct a three-stage queueing game model, analyzing the relationship between the referral threshold of city hospitals and the payment price of community hospitals. Equilibrium decisions for the arrival rate of first-visit patients at city hospitals, the referral threshold of city hospitals, and the optimal payment price of community hospitals are provided. The findings suggest that under optimal payment prices, both city and community hospitals stand to increase their profits. In addition, it is found that relatively lower referral payment prices can effectively coordinate the two hospitals to achieve most of the benefits of the two-tier service system.