Abstract
This study investigates the evolutionary game dynamics of medical knowledge sharing (KS) among Chinese hospitals under government regulation, focusing on the strategic interactions between general hospitals, community health service centers, and governmental bodies. Leveraging evolutionary game theory, we construct a tripartite evolutionary game model incorporating replicator dynamics to characterize the strategic evolution of the involved parties. Our analysis examines the regulatory decisions of the government and the strategic choices of Chinese hospitals, considering critical factors such as KS costs, synergistic benefits, government incentives and penalties, and patient evaluations. The model is analyzed using replicator dynamic equations to derive evolutionary stable strategies (ESSs), complemented by numerical simulations for sensitivity analysis. Key findings reveal that the system’s equilibrium depends on the balance between KS benefits and costs, with government regulation and patient evaluations significantly influencing Chinese hospital behaviors. The results highlight that increasing government incentives and penalties, alongside enhancing patient feedback mechanisms, can effectively promote KS. However, excessive incentives may reduce willingness to regulate, suggesting the need for balanced policy design. This research provides novel theoretical insights and practical recommendations by (1) pioneering the application of a tripartite evolutionary game framework to model KS dynamics in China’s hierarchical healthcare system under government oversight, (2) explicitly integrating the dual influences of government regulation and patient evaluations on hospital strategies, and (3) revealing the non-linear effects of policy instruments. These contributions are crucial for optimizing Chinese medical resource allocation and fostering sustainable collaborative healthcare ecosystems.