社会医疗保险综合评估指标体系研究

发布时间：2018-08-05 09:26

【摘要】：1998年底,城镇职工基本医疗保险制度开始试点实施。2003年起,全国部分县(市)开始进行新型农村合作医疗保险制度(即新农合)试点并逐步推广,到2010年基本实现覆盖全国农村户籍人员。2007年,各地开始建立城镇居民基本医疗保险制度,到2010年已覆盖全体未参加职工医疗保险的城镇户籍人员。社会医疗保险制度不断完善与发展,取得显著成效。但是,目前并没有通用的社会医疗保险综合评估指标体系对其进行评估。本文旨在建立一个能够同时适用于三项医疗保险制度、合理有效的评估指标体系对社会医疗保险进行综合评估。本文主要运用德尔菲法、层次分析法(AHP)、综合指数法等方法。首先,初选并筛选社会医疗保险的评估指标；其次,设定指标权重；再次,建立指标标准值；最后,确定指标指数值。通过以上分析研究过程,构建出一套对社会医疗保险进行综合评估的指标体系,以便在未来实际应用中对医疗保险进行全面有效的评估。具体包括五个部分第一部分,阐述选题背景,提出研究的理论意义和实际意义,综述国内外与本研究相关的研究成果,介绍研究内容、方法、创新点及不足。第二部分,界定社会医疗保险与评估指标的相关概念理论,阐述社会医疗保险综合评估指标体系的五项基本功能及建立社会医疗保险综合评估指标体系的宏微观意义。第三部分,这是本文的重点部分,具体内容为提出建立指标体系所采用的研究方法与指标的遴选原则,初步选择评估指标,对德尔菲法咨询的专家基本信息情况、积极程度及协调程度等分析,最终确定出包括1项一级总目标指标、3项二级指标、10项三级指标、32项四级指标,共计46项评估指标的社会医疗保险综合评估指标体系。第四部分,在前面建立社会医疗保险综合评估指标体系的基础上,本部分重点采用层次分析法确定出各项指标的权重与组合权重,运用综合指数法,确定各项四级指标的属性,指标标准值与指数值,建立社会医疗保险综合评估模型。第五部分,根据建立社会医疗保险综合评估指标体系及综合评估模型的过程,提出结论与政策建议,以期为未来政府等部门建立更加完善的评估指标体系提供帮助。
[Abstract]:At the end of 1998, the basic medical insurance system for urban workers began to be implemented on a pilot basis. Beginning in 2003, some counties (cities) throughout the country began to pilot and gradually popularize the new rural cooperative medical insurance system (NCMS). In 2007, cities and towns began to establish a basic medical insurance system for urban residents, and by 2010, all urban residents who had not participated in medical insurance for workers had been covered. Social medical insurance system continues to improve and develop, with remarkable results. However, there is no universal social health insurance comprehensive evaluation index system to evaluate it. The purpose of this paper is to establish a reasonable and effective evaluation index system which can be applied to three medical insurance systems at the same time. This paper mainly uses Delphi method, Analytic hierarchy process (AHP) (AHP), comprehensive index method and so on. First, primary selection and screening of social health insurance evaluation indicators; secondly, set index weight; third, establish index standard value; finally, determine the index value. Through the above analysis and research process, a set of comprehensive evaluation index system of social medical insurance is constructed in order to evaluate medical insurance comprehensively and effectively in the future practical application. The first part includes five parts, including the background of the topic, the theoretical and practical significance of the research, the review of domestic and foreign research results related to this study, the introduction of research content, methods, innovations and shortcomings. In the second part, the author defines the concept theory of social medical insurance and evaluation index, expounds the five basic functions of social medical insurance comprehensive evaluation index system and the macro and micro significance of establishing social medical insurance comprehensive evaluation index system. The third part, this is the key part of this paper, the concrete content is to put forward the research method and the selection principle of the index system, to select the evaluation index, to the basic information of the experts consulted by Delphi method. Based on the analysis of positive degree and coordination degree, a comprehensive evaluation index system of social medical insurance is established, which includes 1 total target index, 3 indicators, 10 indicators, 3 indicators, and 32 indicators, and a total of 46 evaluation indexes, the index system of social medical insurance comprehensive evaluation is established. The fourth part, on the basis of the establishment of social medical insurance comprehensive evaluation index system, this part focuses on the AHP to determine the weight of each index and the combined weight, using the comprehensive index method to determine the attributes of the four levels of indicators. The standard value and index value of the index are used to establish the comprehensive evaluation model of social medical insurance. The fifth part, according to the establishment of social medical insurance comprehensive evaluation index system and the process of comprehensive evaluation model, put forward conclusions and policy recommendations for the future government and other departments to establish a more complete evaluation index system to provide help.
【学位授予单位】：安徽财经大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：F842.684

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