Is defensive medicine only the responsibility of physicians?
Against the backdrop of doctor-patient shared decision-making,the influence of patients'treatmen-t needs on doctors'defensive treatment behaviors is analyzed from the perspective of unique patients.An evolutionary game model is developed to analyze changes in physician-patient behavior by specifically cap-turing patients'risk aversion degree—A remarkable feature of endogenous treatment needs.The model aims to examine doctor-patient behavior change and explore evolution rules of doctor-patient strategy responding to patients'illness degree.According to the study results,if a patients'degree of risk aversion is lower than a certain threshold,it will induce defensive treatment and promote patient acceptance.Besides,considering the promotion effect of disease severity on patients'refusal behavior,the focus should be on physicians'decisions to treat minor illnesses and reduce financial incentives for defensive treatment.The findings have reference value for improving patients'risk aversion,setting differential reputation punishment,developing subsidies for major diseases,popularizing DRGs fixed payment mode,and extending integrated eldercare services with medical care.
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