首页|基于多维尺度分析和社会网络分析的紧密型县域医共体"打包付费"问题研究

基于多维尺度分析和社会网络分析的紧密型县域医共体"打包付费"问题研究

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目的:探讨我国紧密型县域医共体实施"打包付费"存在的核心问题,以期为紧密型县域医共体医保支付方式创新改革提供有益借鉴.方法:通过卫生系统宏观模型构建问题体系,运用多维尺度分析、社会网络分析对相关文献进行分析,并采用熵权TOPSIS法对其结果进行综合评价,归纳总结出紧密型县域医共体"打包付费"存在的核心问题.结果:我国紧密型县域医共体存在利益分配及激励约束机制不健全(Ci= 1.000)、对医共体缺乏有效的监督考核机制(Ci= 0.732)、医疗服务质量效率受抑制(Ci= 0.652),医疗信息化建设滞后(Ci= 0.595)、配套政策措施不完善(Ci= 0.579)等问题.结论:可从以下3个方面优化紧密型县域医共体"打包付费",(1)应完善多层次协同激励机制,保证服务质量效率;(2)优化总额测算方法,完善配套措施细则;(3)加快信息化建设,强化监管考核管理.
Research on the"Package Payment"Problem of the Compact County Medical Community Based on Multi-Dimension-al Scale Analysis and Social Network Analysis
Objective:To explore the core issues in the implementation of"packaged payment"in China's compact county medi-cal community,in order to provide useful references for the innovative reform of medical insurance payment methods in compact coun-ty medical community.Methods:By constructing the problem system through the macro model of the health system,analyzing the re-lated literature using multidimensional scale analysis and social network analysis,and comprehensively evaluating the results using the entropy-weighted TOPSIS method,it summarizes the core issues of"packaged payment"in compact county medical community.Results:There are core issues in China's compact county medical community,such as inadequate distribution of benefits and incen-tive and constraint mechanisms within the medical community(Ci= 1.000),lack of effective supervision and assessment mechanism for medical communities(Ci= 0.732),suppressed quality and efficiency of medical services(Ci= 0.652),lagging medical informatiza-tion construction(Ci= 0.595),and incomplete supporting policy measures(Ci= 0.579).Conclusion:The"packaged payment"of com-pact county medical community can be optimized from the following three aspects:a multi-level collaborative incentive mechanism should be improved to ensure the service quality and efficiency;optimize the total amount calculation method and improve the de-tailed supporting measures;accelerate information construction and strengthen supervision and assessment management.

compact county medical communitytotal paymentmulti-dimension scalingsocial network analysis

黄凌波、张兴隆、刘佩芸、彭蓉、覃娴静、冯启明

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广西医科大学卫生与健康政策研究中心(广西高端智库建设培育单位) 南宁 530021

广西医科大学信息与管理学院 南宁 530021

紧密型县域医疗共同体 总额付费 多维尺度分析 社会网络分析

广西自然基金青年科学基金项目广西卫生健康委委托项目广西特色新型智库联盟重点课题

2020JJB180002

2024

中国卫生经济
中国卫生经济学会,卫生部卫生经济研究所

中国卫生经济

CSTPCDCHSSCD北大核心
影响因子:1.524
ISSN:1003-0743
年,卷(期):2024.43(1)
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