Study on the evolutionary strategy of upward patient transfer in the loose medical consortia.

Medical institutions in loose medical consortia tend to have poor cooperation due to fragmented interests. We aim to explore any issues associated with patient upward transfer in a loose medical consortium system consisting of two tertiary hospitals with both cooperative and competitive relationships. A two-sided evolutionary game model was constructed to assess the stability of equilibrium strategy combinations in the process of interaction between game players under different cost-sharing scenarios and different degrees of penalties when running patient upward transfer between super triple-A hospitals (STH) and general triple-A hospitals (GTH).