多维视角下医保基金监管治理创新综合分析框架构建

The Construction of a Comprehensive Analysis Framework for Medical Insurance Fund Supervision and Governance Innovation from a Multi-Dimensional Perspective

目的针对医疗保障基金监管过程中所面临的乱象问题,探讨其复杂网络关联机制、问题根源和成因,开展相关概念和综合分析框架研究。方法通过文献回顾和政策分析法,对医疗保障基金监管创新治理模式内涵及要素及综合分析框架构建展开分析。结果基于嵌套复杂监管网络空间理论探索性提出医疗保障基金监管治理创新模式的概念内涵和要素,并从4个空间向量维度构建了涵盖:"宏观—中观—微观"多层次,"关键问题—关键节点—薄弱环节"多视角,以及"治理主体—功能"维度和"监管制度—机制—手段"等多维视角医疗保障基金监管治理创新的综合分析框架。结论医疗保障基金监管问题复杂乱象的系统解决,需要探索新的监管治理模式和新路径,需要探索新的理论分析框架指导实践。

Objective Because of the chaotic problems faced in the supervision of medical security funds,the complex network linkage mechanism,the root causes and causes of the problems are explored,and related concepts and comprehensive analysis frameworks are carried out.Method Through literature review and policy analysis,the connotation and elements of the medical security fund regulatory innovation governance model and the construction of a comprehensive analysis framework are analyzed.Results Based on the theory of nested complex regulatory cyberspace,the concept connotation and elements of the medical security fund regulatory governance innovation model are exploratively proposed.Spatial vector dimensions of"macro-medium-micro"multi-level,"key issues-key nodes-weak links"multi-view,"Governance subject-function"dimension and"supervision system-mechanism"methods are constructed to make a comprehensive analysis framework for the innovation of medical security fund supervision and governance.Conclusion To systematically solve the complicated and chaotic problems of medical security fund supervision,it is necessary to explore new regulatory governance models and new paths,and to explore new theoretical analysis frameworks to guide practice.