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Fig 1.

There was a logical relationship among the primary diagnosis, hierarchical diagnosis and treatment system, and remote consultation.

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Fig 1 Expand

Fig 2.

The downward allocation of medical resources can improve the capacity and quality of primary health services.

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Table 1.

Parameter symbols and meanings.

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Table 1 Expand

Table 2.

Revenue matrix for THs and PHs.

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Table 2 Expand

Table 3.

Local stability analysis of equilibrium points in the hierarchical hospital evolutionary system.

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Table 3 Expand

Fig 3.

The trajectory of interactive dynamic evolution in establishing remote consultation systems between THs and PHs.

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Fig 3 Expand

Table 4.

Table of parameter assignments.

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Table 4 Expand

Fig 4.

The dynamic evolutionary trends of establishing remote consultation systems in THs and PHs.

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Fig 5.

The impact of changes in the resource sinking utility E on system evolution.

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Fig 6.

The impact of changes in reputational damage and adverse consequences Q1 on system evolution.

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Fig 7.

The impact of changes in reputational damage and adverse consequences Q2 on system evolution.

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Fig 8.

The impact of changes in the distribution proportion of government subsidies α on system evolution.

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Fig 9.

The impact of changes in the economic benefit allocation ratio β on system evolution.

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Fig 10.

The impact of changes in the proportion of effectiveness in utility derived from the downward allocation of medical resources ϕ on system evolution.

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Fig 11.

The combined influence of simultaneous modifications α, β and ϕ on the system’s evolutionary trajectory.

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