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
Research on the"Package Payment"Problem of the Compact County Medical Community Based on Multi-Dimension-al Scale Analysis and Social Network Analysis
黄凌波 1张兴隆 1刘佩芸 1彭蓉 1覃娴静 1冯启明1
作者信息
- 1. 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
- 折叠
摘要
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.
Abstract
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.
关键词
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Key words
compact county medical community/total payment/multi-dimension scaling/social network analysis引用本文复制引用
基金项目
广西自然基金青年科学基金项目(2020JJB180002)
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()
出版年
2024
NETL
NSTL
万方数据