| 引用本文：龚光雯, 唐昌敏, 郭丹丹, 陈迎春.县域医共体总额预付激励效应的影响因素研究——基于24个案例的清晰集定性比较分析[J].中国卫生政策研究,2023,16(7):10-15 |
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| 县域医共体总额预付激励效应的影响因素研究——基于24个案例的清晰集定性比较分析 |
| 投稿时间：2023-05-28 修订日期：2023-06-29 PDF全文浏览 HTML全文浏览 |
| 龚光雯1,2, 唐昌敏1,2, 郭丹丹3, 陈迎春3,4 |
1. 湖北中医药大学管理学院 湖北武汉 430065;
2. 湖北省高校人文社科研究基地中医药研究发展中心 湖北武汉 430065;
3. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;
4. 湖北省人文社科重点研究基地农村健康服务研究中心 湖北武汉 430030 |
| 摘要:目的：发现影响制约医共体医保总额预付改革激励效应的因素，为促进县域医共体医保总额预付改革提供研究证据。方法：以样本地区医共体医保总额预付政策文本及其激励效应为研究对象，采用清晰集定性比较分析方法揭示医共体医保总额预付模式的设计要素与其激励效应之间的因果关系。结果：超支分担、购买服务范围、结算方式是影响医共体医保总额预付方案激励效应的决定性因素。结论：采取供方承担超支风险、购买服务范围包含县域外医疗服务和预付制结算方式的设计，有利于提高医共体医保总额预付模式的激励效应。 |
| 关键词:县域医共体 医保 总额预付 激励效应 定性比较分析 |
| 基金项目:国家自然科学基金面上项目(71974066) |
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| A study on the influencing factors of total prepayment incentive effect of county medical communities:A clear set qualitative comparative analysis based on 24 cases |
| GONG Guang-wen1,2, TANG Chang-min1,2, GUO Dan-dan3, CHEN Ying-chun3,4 |
1. School of management, Hubei university of Chinese Medicine, Wuhan Hubei 430065, China;
2. Research Center for the Development of Traditional Chinese Medicine, Key Research Base of Humanities and Social Sciences of Hubei province, Wuhan Hubei 430065, China;
3. School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Hubei 430030, China;
4. Rural Health Service Research Center, Hubei Key Research Base of Humanities and Social Sciences, Wuhan Hubei 430030, China |
| Abstract:Objective: To identify what factors affect the incentive effect of the reform of total medical insurance prepayment in the medical community, and to provide research evidence for improving the total medical insurance prepayment of the county medical community. Methods: Text of the total medical insurance prepayment policy and its incentive effects in sample regions is taken as the research object, and a clear set qualitative comparative analysis method is used to reveal the causal relationship between the design elements of the total medical insurance prepayment and its incentive effects. Results: It is found that overspending sharing, purchasing service scope, and settlement method are the main factors that affect the incentive effect oftotal medical insurance prepayment plan of the medical community. Conclusions: Adopting the design of the supplier bearing the risk of overspending, purchasing service scope including medical services outside the county, and adopting a prepayment settlement method are conducive to improving the incentive effect of the total medical insurance of the medical community. |
| Key words:County medical communities Medical insurance Total prepayment budget Incentive effects Qualitative comparative analysis |
| 摘要点击次数: 1070 全文下载次数: 500 |
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