Research on the Governance Path of Medical Ethics Risks and the Logical Causes of Profit-seeking Behavior
Under the diagnosis related groups (DRG) medical insurance system, medical institutions are in a dominant position in the control of healthcare information, providing them with opportunities to maximize their benefits. Consequently, numerous ethical risks arise, posing significant challenges to refo...
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| Format: | Article |
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Editorial Office of Medicine and Philosophy
2025-02-01
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| Series: | Yixue yu zhexue |
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| Online Access: | https://yizhe.dmu.edu.cn/article/doi/10.12014/j.issn.1002-0772.2025.04.10 |
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| author | Juan LI Zhenping LIN |
| author_facet | Juan LI Zhenping LIN |
| author_sort | Juan LI |
| collection | DOAJ |
| description | Under the diagnosis related groups (DRG) medical insurance system, medical institutions are in a dominant position in the control of healthcare information, providing them with opportunities to maximize their benefits. Consequently, numerous ethical risks arise, posing significant challenges to reform efforts. By summarizing the types and specific manifestations of medical ethical risks, this paper analyzes the causes of behavior motivation from both macro-policy and micro-institutional perspectives. The study believes that the ethical risks stem from inadequate macro-level policy regulation and the short-sighted management regarding the conflict between economic expansion and public welfare under micro-level institutional frameworks. Risk behaviors result from ineffective transmission of incentive mechanisms under DRG-based payment and the misinterpretation of cost incentives by medical institutions, leading to behavioral distortions that fulfill both economic and social interests. To address these issues, the study proposes establishing an early warning system for payment weight fluctuations to raise the ethical risk entry threshold and introducing AI-assisted coding to tighten risk pathways. |
| format | Article |
| id | doaj-art-de5dafdba0064a87aceebc08ca92f493 |
| institution | Kabale University |
| issn | 1002-0772 |
| language | zho |
| publishDate | 2025-02-01 |
| publisher | Editorial Office of Medicine and Philosophy |
| record_format | Article |
| series | Yixue yu zhexue |
| spelling | doaj-art-de5dafdba0064a87aceebc08ca92f4932025-08-20T03:27:21ZzhoEditorial Office of Medicine and PhilosophyYixue yu zhexue1002-07722025-02-01464515510.12014/j.issn.1002-0772.2025.04.104-lijuanResearch on the Governance Path of Medical Ethics Risks and the Logical Causes of Profit-seeking BehaviorJuan LI0Zhenping LIN1School of Health Policy & Management, Nanjing Medical University, Nanjing 210029, ChinaSchool of Health Policy & Management, Nanjing Medical University, Nanjing 210029, ChinaUnder the diagnosis related groups (DRG) medical insurance system, medical institutions are in a dominant position in the control of healthcare information, providing them with opportunities to maximize their benefits. Consequently, numerous ethical risks arise, posing significant challenges to reform efforts. By summarizing the types and specific manifestations of medical ethical risks, this paper analyzes the causes of behavior motivation from both macro-policy and micro-institutional perspectives. The study believes that the ethical risks stem from inadequate macro-level policy regulation and the short-sighted management regarding the conflict between economic expansion and public welfare under micro-level institutional frameworks. Risk behaviors result from ineffective transmission of incentive mechanisms under DRG-based payment and the misinterpretation of cost incentives by medical institutions, leading to behavioral distortions that fulfill both economic and social interests. To address these issues, the study proposes establishing an early warning system for payment weight fluctuations to raise the ethical risk entry threshold and introducing AI-assisted coding to tighten risk pathways.https://yizhe.dmu.edu.cn/article/doi/10.12014/j.issn.1002-0772.2025.04.10diagnosis related groupsethical riskbehavioral logic |
| spellingShingle | Juan LI Zhenping LIN Research on the Governance Path of Medical Ethics Risks and the Logical Causes of Profit-seeking Behavior Yixue yu zhexue diagnosis related groups ethical risk behavioral logic |
| title | Research on the Governance Path of Medical Ethics Risks and the Logical Causes of Profit-seeking Behavior |
| title_full | Research on the Governance Path of Medical Ethics Risks and the Logical Causes of Profit-seeking Behavior |
| title_fullStr | Research on the Governance Path of Medical Ethics Risks and the Logical Causes of Profit-seeking Behavior |
| title_full_unstemmed | Research on the Governance Path of Medical Ethics Risks and the Logical Causes of Profit-seeking Behavior |
| title_short | Research on the Governance Path of Medical Ethics Risks and the Logical Causes of Profit-seeking Behavior |
| title_sort | research on the governance path of medical ethics risks and the logical causes of profit seeking behavior |
| topic | diagnosis related groups ethical risk behavioral logic |
| url | https://yizhe.dmu.edu.cn/article/doi/10.12014/j.issn.1002-0772.2025.04.10 |
| work_keys_str_mv | AT juanli researchonthegovernancepathofmedicalethicsrisksandthelogicalcausesofprofitseekingbehavior AT zhenpinglin researchonthegovernancepathofmedicalethicsrisksandthelogicalcausesofprofitseekingbehavior |