中国农村住院患者无序、趋高就医现象突出，带来卫生资源配置和使用效率的低下。住院患者合理流动是指患者依据自身实际健康状况的需求、疾病严重程度，通过各层级医疗机构的上下协作，选择适当层级的医疗机构获得适宜的住院服务的过程。本研究在调查分析县域内农村住院患者住院机构选择特征基础上，探究合理流动阻力，构建不合理流动决策机制，并从微观主体角度构建合理流动阻力传导系统；在此基础上，对阻力强度及可控性进行量化分析，构建合理流动最小累积阻力模型，进而进行实证分析，评估患者实际流动风险及医保政策引导效力。研究中以累积前景理论为基础，采用实验研究、随机信念学习模型等方法构建不合理流动形成机制，并借助因果关系图绘制阻力传导系统；通过德尔菲法及现场调查测量阻力强度以及可控性，构建合理流动最小累积阻力模型。本研究对推进分级诊疗制度，提高县乡卫生资源使用效率，缓解农村居民看病难看病贵问题具有较高的理论价值与现实意义。

The phenomenon of seeking medical services in higher hospital is prevailing in rural areas of China, which brings about the low efficiency of health resources allocation and utilization. Rational flow is refers to such situation that hospitalized patients choose appropriate levels of medical institutions to obtain appropriate inpatient service according to health requirements, disease severity and cooperation of all levels of medical institutions. Based on the analysis of characteristics of rural inpatients’ flow, the study finds out resistance factors of rational flow, and its interrelationship in the view of microcosmic actors to build forming mechanism of Irrational flow; Meanwhile , resistance factors’ intensity and controllability are measured in order to build a minimum cumulative resistance model which can be used to assess the actual liquidity risk of patients and the effectiveness of health insurance policy. On the basis of Cumulative Prospect Theory, experimental methodology and belief learning model are used to explore the resistance factors of hospitalized patients flow, and build resistance system with the causal diagram and forming mechanism of irrational flow of rural inpatients. What’s more, Delphi method and contextual inquiry are used to build a minimum cumulative flow resistance model. The research has a high theoretical value and practical significance for promoting two-way referral system, increasing the efficiency of resources of county and village medical organization, and alleviating the problem of Difficulty getting medical service and high cost in rural areas of China.