Evolutionary game model for the behavior of private sectors in elderly healthcare public–private partnership under the condition of information asymmetry

Chinese elderly healthcare services face problems of poor service quality, difficulty in eliminating hidden quality risks, and inadequate government supervision, primarily due to information asymmetry and insufficient supervision among providers, users, and regulatory bodies. The study addresses two key questions: How does information asymmetry influence private sector strategies in elderly healthcare public–private partnership (PPP), and what regulatory models can overcome the potential shortcomings? The study examines the influence of information asymmetry, particularly on "experience" and "credence," crucial for governance and service quality in elderly healthcare PPPs in China. By developing the novel methodology of evolutionary game theory and employing MATLAB simulations, this study analyzes private sector behavior under two distinct regulatory models. The research findings reveal a significant disparity, under the traditional "single" model; private sectors often prioritize low-quality services driven by self-interest or inadequate penalties, while the collaborative model incentivizes them to deliver higher-quality services influenced by factors such as public participation, reputational incentives, and penalties. Therefore, the paper proposed a multifaceted regulatory model based on strengthening third-party evaluation mechanisms, encouraging public participation, and refining reward and penalty systems. This proposed model will not only significantly contribute to regulatory effectiveness and quality services within elderly healthcare PPP projects, but will also serve as a reference point for government decision-makers responsible for quality services within PPP projects.