基于社会网络理论的医疗非正式支付现象分析与启示

医疗非正式支付现象是医疗机构与社会深层次的原因共同造成的，并在医患双方互动过程中产生，受各种因素影响，是医疗卫生行业重点治理内容，同时也是医院行风建设重点防治对象。引入社会网络理论，从患者视角分析了网络规模、网络异质性、社会规范、社会信任对医疗非正式支付的影响，从医生视角分析了网络异质性和社会规范对医疗非正式支付的影响。基于医患双方社会网络各要件的角色与运行逻辑，提出对医疗非正式支付问题治理的建议：营造杜绝医疗非正式支付行为的就医氛围，构建和谐医患关系的网络生态环境，引导非正式支付转为医院公益基金，加强对医生的社会规范机制建设。

Analysis and Implications of Informal Payment in Healthcare Based on Social Network Theory

The phenomenon of informal payments in healthcare is the result of complex factors involving both healthcare institutions and society. It emerges in the interactive process between healthcare providers and patients, influenced by various factors, making it a focal point for governance in the healthcare industry, and also key prevention and control target for hospital professional ethos construction. Based on social network theory, this article analyzed the effect of network size, network heterogeneity, social norms, and social trust on informal healthcare payments from the patient's perspective, and the effect of network heterogeneity and social norms from the doctor's perspective. In view of the role and operation logic of the social network elements of doctor and patient, the study proposed suggestions on governance of informal payments in healthcare: fostering an environment that discourages the informal payment behavior, building a network ecological environment to foster harmonious doctor-patient relationships, guiding informal payments to be transformed into hospital public welfare fund, and strengthening the construction of social norm mechanism for doctors.