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基于PMC指數模型的我國醫保支付方式改革政策量化與評價分析

Quantifi cation and evaluation of China's reform on medical insurance payment methods: based on PMC index model

作者:

李祥飛   張振   于佳卉   敖治華

單位:

天津,天津工業大學經濟與管理學院

關鍵詞:

醫保支付方式;文本挖掘;PMC 指數模型;量化評價

分類號:

R95; R197

DOI:

10.3969/j.issn.2095-7432.2023.01.006

出版年,卷(期),頁碼:2023,13 (1):33-39

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摘要:

目的 對我國國家層面發布的醫保支付方式改革政策進行文本分析與量化評價,為改革政策的制定和完善提供理論依據。方法 運用文本挖掘方法深入分析2009年—2021年我國國家層面發布的13項醫保支付方式改革政策的內容,以此為基礎構建醫保支付方式改革政策評價的量化框架,利用PMC指數模型進行量化分析和曲面圖繪制。結果 PMC指數模型結果表明,我國13項醫保支付方式改革政策PMC指數的平均值為7.91,總體表現良好,其中3項政策表現優秀,7項政策表現良好,3項政策表現及格。結論 我國醫保支付方式改革政策基本完善,政策性質、政策作用方式較為明確,但在政策時效、政策級別、政策視角、政策措施等方面存在一些薄弱環節,仍存在較大的提升空間,建議著重從政策級別、政策時效、政策視角、政策措施等方面進行具體分析并進行改進。

英文摘要:

Objective To perform text analysis and quantitative evaluation of the reform policies of medical insurance payment methods issued at the national level in China, thus providing a theoretical basis for the development and optimization of reform policies. Methods The text mining method was used to deeply analyze the content of 13 medical insurance payment reform policies released at the national level in China from 2009 to 2021. Accordingly, a quantitative framework for the evaluation of medical insurance payment

reform policies was constructed, and the Policy Modeling Consistency (PMC) index model was used for quantitative analysis and surface plotting. Results The PMC index model showed that the average PMC index value of the 13 medical insurance payment reform policies in China was 7.91, indicating a relatively good overall performance. Among these policies, the performance was excellent for 3 policies, good for 7 policies, and fair for 3 policies. Conclusions China's medical insurance payment reform policy is basically perfect, with well-defi ned nature and roles. However, there are some weak points in terms of policy timeliness, policy level, policy perspective, and policy measures, which require further improvements. This article analyzed these weak points and proposed suggestions for improvement.

基金項目:

國家社會科學基金一般項目(22GBL223

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