社会医疗保险风险因素分析及其综合评价

Risk factors analysis and fuzzy synthetic evaluation of social medical insurance

为了探索完善社会医疗保险问题的对策,建立了风险影响因素指标体系,并运用解释结构模型进行各影响因素的逻辑层次划分,然后运用层次分析法和模糊综合评价方法,进行了定量评价分析。结果显示我国社会医疗保险风险水平还处于较高的境地,需要进一步完善社会保障范围和保障体系,需要采取多渠道筹集资金,并且要规范医保各方行为,建立可操作的医疗保险基金监督机制。

In order to explore the countermeasure of improving the social medical insurance, the index system of risk factors was established and the logical level division of each influencing factor was carried out using the explanation of structural model, making the quantitative analysis using the analytic hierarchy process and the fuzzy synthetic evaluation. The results showed that our country＇s social health insurance also has a higher risk level, needs to further expand the scope of the social medical insurance, fund - raising for multi - channel, and needs to regulate the conduct of parties of the health insurance and the establishment of operational mechanisms for monitoring the medical insurance fund.