A novel graph model for resolving power-asymmetric conflicts: Application in hierarchical diagnosis and treatment systems

Abstract

As Chinese society undergoes rapid aging and urbanization, the existing medical service system faces significant challenges, including unequal resource distribution, a shortage of high-quality resources, and inefficient allocation. To address these issues, the hierarchical diagnosis and treatment system (HDTS) has been introduced to optimize medical resource allocation and utilization. However, implementing HDTS encounters complex conflicts of interest among multiple decision-makers (DMs), compounded by ambiguity, uncertainty, and power asymmetry. This paper proposes the power-asymmetric additive graph model for conflict resolution (PAAGMCR), a versatile tool that integrates qualitative and quantitative methods to address stakeholder conflict in HDTS implementation in Shandong, China. The optimal solution $s_{18}$ can be identified using PAAGMCR: the Shandong Provincial Government should standardize medical treatment processes in tertiary hospitals, invest in grassroots medical facilities, allocate funds for public awareness campaigns, and encourage patients to seek initial treatment at the grassroots level. Tertiary hospitals should collaborate with grassroots hospitals to utilize subsidies for equipment upgrades and workforce training. Patients and their families should adhere to HDTS principles and make informed healthcare decisions. Furthermore, this study outlines an evolutionary path from the initial to the optimal state, offering theoretical support for resolving real-world conflicts. Finally, strategic recommendations are provided according to the analysis result of the conflict to guide DMs in implementing HDTS effectively.