Abstract:

Due to the improvement of people's health awareness and implement of the ‘Big Health’ government strategy， lots of health service institutions have been established one after another and a new kind of health service supply chain forms in China. The key operation problems in these supply chains， such as service pricing and quality of health service institution and service quality of hospital， are studied innovatively based on the referral between health service institutions and hospitals in the paper.A patient utility model， centralized and decentralized supply chain operations model are built for analyzing the impact of referral service fee on the optimal pricing， service quality and profit. The function of referral rate is this paper’s highlight which is related to health complexity and health service quality. Because the health service supply chain’s efficiency is lowered by the existence of referral service fee， the coordination of supply chain is dealt with by the penalty contract and cost sharing contract.It is found that　（1） in a centralized health service supply chain， the optimal health service quality， medical service quality and service pricing can be obtained simultaneously. When health service quality and medical service quality are first determined， the health service price is increased with two service quality above. And then if the medical service quality is first determined， health service quality is negatively correlated with it. Two kind of service qualities are decreased with the health complexity. Health service quality is negatively correlated with referral rate， and health service price and medical service quality are decreased with referral rate. （2） In the decentralized health service supply chain， the medical service quality is decreased with that of health and related with referral service fee， but it is independent of the health service price. Given some an operation condition， the health service quality， medical service quality and the overall profit of the supply chain is decreased with the referral service fee. The profit of health service institutions is also decreased with the referral service fee， while that of hospital is first increased and then decreased. （3） Under a condition， the Pareto improvement of the health service supply chain can be achieved by the penalty contract， but the coordination cannot be realized. While the health service supply chain can be coordinated by the cost sharing contract.

Key words: health service supply chain, service quality, pricing, referral rate