| 引用本文：杨昊韵, 张晓, 丁晨钰.基于SWOT分析的江苏省职工医保门诊共济优化路径设计[J].中国卫生政策研究,2022,15(3):22-28 |
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| 基于SWOT分析的江苏省职工医保门诊共济优化路径设计 |
| 投稿时间：2022-01-24 修订日期：2022-02-28 PDF全文浏览 HTML全文浏览 |
| 杨昊韵, 张晓, 丁晨钰 |
| 东南大学公共卫生学院 江苏南京 210009 |
| 摘要:目的：了解江苏省职工医保门诊共济机制发展环境，为其优化路径设计提供依据。方法：运用SWOT分析法探讨江苏省职工医保门诊共济机制运行的优势与劣势，面临的机遇与威胁。结果：江苏省职工医保门诊共济机制的发展有着财务基础、经办管理、医疗机构、政策导向、现实需求、数字医保背景等多方位的优势与机遇，但面临着法律体系、基金监管、协议管理、参保观念、筹资标准、待遇水平、疫情冲击等层面的劣势与威胁。结论：建立SWOT矩阵，从四个组合策略维度出发，综合分析相关对策，设计江苏省职工医保门诊共济机制的优化路径。 |
| 关键词:职工医保 门诊共济 SWOT分析 路径设计 |
| 基金项目:江苏省医疗保险研究会资助项目:医疗保险门诊共济保障机制研究 |
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| Optimized path on outpatient coordination mechanism for medical insurance of urban employees in Jiangsu Province based on SWOT analysis |
| YANG Hao-yun, ZHANG Xiao, DING Chen-yu |
| School of Public Health, Southeast University, Nanjing Jiangsu 210009, China |
| Abstract:Objective: To understand the development environment of outpatient co-ordination system mechanism for employee medical insurance in Jiangsu Province, provide a basis for the design of its optimized path. Methods: SWOT analysis was used to explore the advantages and disadvantages of outpatient co-ordination system mechanism for employee medical insurance in Jiangsu Province, and the opportunities and threats it is faced with. Results: The development of outpatient co-ordination system mechanism for employee medical insurance in Jiangsu Province has many advantages and opportunities, such as financial basis, handling management, medical institutions, policy orientation, actual demand and digital medical insurance background, but also faced with disadvantages and threats in the aspects of legal system, fund supervision, agreement management, concept of insurance participation, financing standard, treatment levels and epidemic impact. Conclusions: A SWOT matrix was established, starting from four combined strategy dimensions, relevant countermeasures were comprehensively analyzed, and the optimized path of outpatient co-ordination system mechanism for employee medical insurance in Jiangsu Province was designed. |
| Key words:Medical insurance for urban employees Outpatient coordination SWOT analysis Path design |
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