| 引用本文：周绿林, 白焓斌.医保经办服务数字化转型的路径研究——基于22个案例的模糊集定性比较分析[J].中国卫生政策研究,2024,17(7):18-24 |
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| 医保经办服务数字化转型的路径研究——基于22个案例的模糊集定性比较分析 |
| 投稿时间：2024-05-17 修订日期：2024-06-29 PDF全文浏览 HTML全文浏览 |
| 周绿林, 白焓斌 |
| 江苏大学管理学院 江苏镇江 212013 |
| 摘要:目的：实证分析医保经办服务数字化转型的多元驱动路径，以期为医保经办提质增效提供有益参考。方法：基于TOE理论构建医保经办服务数字化转型影响因素的理论分析框架，选取22个2022—2023年全国医保经办服务与数字化相关的典型案例作为分析样本，运用模糊集定性比较分析法，从技术、组织、环境三个维度选取6个条件变量分析其对医保经办服务数字化转型的影响。结果：单个条件变量不构成推进数字化转型的必要条件，条件组合后发现4个可以促进数字化转型的组态，基于研究结果归纳出政策支持—技术驱动型(R1+R3)、资源禀赋—系统协同型(R2)、资源有限—开拓发展型(R4)三种可行路径。结论：医保经办服务实现数字化转型的路径具有异质性，不同条件变量之间的联动和组合会形成不同的转型路径。 |
| 关键词:医保经办服务 数字化转型 模糊集定性比较分析 TOE框架 |
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| Research on the path of digital transformation of medical insurance management services: A fuzzy-set qualitative comparative analysis based on 22 cases |
| ZHOU Lyu-lin, BAI Han-bin |
| School of Management, Jiangsu University, Zhenjiang Jiangsu 212013, China |
| Abstract:Objective: This study empirically analyzes the multiple driving paths for digital transformation of medical insurance management services, in order to provide useful references for improving the quality and efficiency of medical insurance management services. Methods: Based on TOE theory, the theoretical analysis framework of the influencing factors of the digital transformation of medical insurance management services was constructed. 22 typical cases related to the digitalization of medical insurance management services in China from 2022 to 2023 were selected as analysis samples, and six conditional variables were selected from the three dimensions of technology, organization and environment to analyze their impact on the digital transformation of medical insurance management services by using the fuzzy-sets qualitative comparative analysis method.Results: A single antecedent condition does not constitute a necessary condition for promoting digital transformation, and four configurations that can promote digital transformation are found, and three feasible paths are summarized based on the research results: “policy support-technology driven”(R1+R3),“resource endowment-system collaboration” (R2), and “limited resources- pioneering development” (R4). Conclusion: The path of digital transformation of medical insurance management services is heterogeneous, and the linkage and combination of different conditional variables will form different transformation paths. |
| Key words:Medical insurance management services Digital transformation Fuzzy-set qualitative comparative analysis TOE framework |
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