智慧医保建设中数据管理能力评估与优化研究

Research on Evaluation and Optimization of Data Management Capability in the Construction of Smart Healthcare Insurance

目的对智慧医保建设中数据管理能力进行评估,提升医保数据管理能力。方法运用数据管理能力成熟度评估模型(DCMM)进行评估。结果我国智慧医保的数据管理能力成熟度等级尚处于“初始级”“受管理级”水平。结论造成智慧医保建设中数据管理水平薄弱的原因,主要包括数据管理协同发展不平衡、操作和执行层面政策支持不充分、数据管理组织人才队伍建设滞后,以及与经济社会大数据对接不足。结合DCMM提出促进智慧医保发展的政策建议,包括加强智慧医保建设中数据安全管理、完善医保数据架构和标准、实施常态化数据管理机制。

Objective In order to improve the management capability of smart healthcare insurance data,this study assessed the data management capability in the construction of smart healthcare insurance.Methods Assessment was performed using the Data Management Capability Maturity Assessment Model(DCMM).Results In general,the maturity level of China’s smart healthcare insurance data management capability was still at the"initial level"or"managed level".Conclusion The reasons affecting the weak level of data management of smart healthcare insurance mainly included unbalanced coordinated development of data management,insufficient policy support at the operational and execution levels,lag in the construction of talent teams in data management organizations,insufficient connection with economic and social big data.Based on the DCMM model,the article puts forward policy recommendations to promote the development of smart healthcare insurance,which include that ensuring the security of smart healthcare insurance data,improving the structure and standards of smart healthcare insurance data,implementing a normalized data management mechanism.