Abstract: Highlights•A credible and practical scheme (BtRaI) is used to enhance the quality and efficiency of healthcare services.•We propose a comprehensive and credible reputation assessment method to suppress malicious scoring attacks.•We propose a consensus mechanism with high fault tolerance and efficiency.•Reputation-based token rewards and penalties are designed to encourage improvements in service quality.•Our scheme (BtRaI) can be effectively applied to healthcare service incentives in dynamic and complex scenarios.
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