加权秩和比法在医保基金运行风险预警评价中的探索性研究——基于成都市数据的分析

Exploratory Study on Weighted Sum of Ranks Method for Early Warning Evaluation of Medical Insurance Fund Operation Risk——Based on the Analysis of Chengdu Data

目的 :探讨加权秩和比法(Weight Rank Sum Ratio,WRSR)在城镇职工基本医疗保险基金风险预测中的应用效果,为医疗保险基金综合评价方法提供实证分析依据。方法 :采用秩和比法(Rank Sum Ratio,简称RSR)对成都市21个区(市)县的城镇职工基本医疗保险基金运行情况进行综合评价;并根据RSR分档要求将评价对象分档。结果 :评价对象共分为高、中、低3档。经F检验,3档WRSR值间差异有统计学意义(F=1096,P<0.0001)。结论 :加权秩和比法是一种计算简便又实用的方法,可对全市各区(市)县城镇职工基本医疗保险基金风险进行分档排序,有利于从整体上掌握一个地区医疗保险基金运行情况。

Objective:To explore the application effect of weighted rank sum ratio(WRSR)method in the risk prediction of basic medical insurance fund for urban employees,and to provide an empirical basis for the comprehensive evaluation of medical insurance funds.Methods:The operation of basic medical insurance fund for urban workers and staff members in21districts(cities)and counties was evaluated by RSR.And according to the RSR sub fi le requirements,the evaluation objects will be classifi ed.Results:The subjects were divided into3categories:high,middle and low.By F test,the diff erence of WRSR value between the3fi les was statistically signifi cant(F=1096,P<0.0001).Conclusion:WRSR is a simple and practical method.It can sort out the risk of medical insurance fund for all districts(cities),which is good for mastering the operation of a regional medical insurance fund as a whole.