医疗保险制度评估框架与指标体系研究

Research on Evaluation Framework and Index System of Medical Insurance System

目的:设计构建医疗保险制度的评估框架与指标体系。方法:将社会学关注的"公平、效率、质量"与管理学关注的管理主要环节"制度、经办、运行、制约因素"两种思维进行融合,提出医疗保险制度评估的指标体系。结论:可以从"制度的公平"、"管理的效率和透明"、"运行结果"及"宏观环境和制约因素"四个维度对医疗保险制度进行评估。

Objective To design and construct an assessment framework and indicator system for the medical insurance system.Methods The“fairness,efficiency,quality”of sociology concerns and the main aspects of management management,such as“institution,operation,operation,and constraints”,were combined to propose an indicator system for medical insurance system evaluation.Conclusion The assessment of the medical insurance system can be carried out from the four dimensions of“system fairness”,“management efficiency and transparency”,“operational results”and“macro environment and constraints”.