Cost Optimization Estimation of Medical Institutions in the Hierarchical Medical System Based on System Dynamics Model.

The grading diagnosis and treatment system in China is to improve the first-time diagnosis rate of patients in primary health care institutions, thereby increasing the proportion of people in primary health care institutions, thus achieving the goal of reducing costs. This study constructs a system dynamics model of the number of primary and upper-level visits—the cost of medical institutions, and simulates the effect of the increase in the proportion of patients attending the primary level on the cost of medical institutions. The study found that with the increase in the number of visits, the cost of primary medical institutions will increase, but the total cost of the entire medical system will be reduced significantly. Moreover, the higher the proportion of the number of people attending the primary level, the lower the total cost. If the proportion of primary care in 2017 increases by 15%, and this trend is maintained until 2021, the total cost saved by medical institutions in 2021 will be as high as 903.32 billion yuan.