基于三维政策工具分析框架的我国医保支付方式改革政策量化分析
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天津工业大学

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天津哲学社会科学规划项目-天津市医保支付方式改革推动分级诊疗的路径与对策研究(TJGL21-019),国家自然科学基金项目(面上项目,重点项目,重大项目)


Text quantitative analysis of China's medical insurance payment reform policy based on three-dimensional policy tool framework
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Tiangong University

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Tianjin Philosophy and Social Science Planning Project - Research on the Path and Countermeasures of Tianjin Medical Insurance Payment Reform to Promote Hierarchical Diagnosis and Treatment

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    摘要:

    为全面剖析我国医保支付方式改革政策发布特征和内容,并提出未来深化改革的政策建议,本研究通过系统检索,获取了2009年—2021年我国国家层面的171份医保支付方式改革政策文本,运用统计学相关方法、社会网络分析法、内容分析法,在对政策条目进行历时分析和发布机构分析的基础上,构建基于“政策工具—政策目标—政策力度”的三维分析框架,进一步对政策内容进行多维量化分类和交叉对比分析。研究发现,在政策分析框架下,政策工具丰富多元,但内部分布不均衡;改革注重服务质量提升,但各个目标之间分布差异较大;力度高的专门文件数量较少,总体调控能力偏低;各交叉维度分析分别呈现不同程度的错配和结构失衡。建议应完善政策内部结构,增强政策工具运用的均衡性;发挥政策目标—力度协同效应,提高改革各方面需求的契合性;破除制约政策体系完善的制度因素,从根本上推动改革发展。

    Abstract:

    In order to comprehensively analyze the characteristics and contents of the policy release of medical insurance payment reform in China, and put forward policy suggestions for deepening reform in the future, this study obtained 171 medical insurance payment reform policy texts at the national level in China from 2009 to 2021 through systematic retrieval. Using statistical methods, social network analysis methods, content analysis methods, based on the diachronic analysis of policy items and the analysis of publishing institutions, a three-dimensional analysis framework based on ' policy tools-policy objectives-policy strength ' was constructed, and further multi-dimensional quantitative classification and cross-comparative analysis of policy content were carried out. The study found that under the framework of policy analysis, policy tools are rich and diverse, but the internal distribution is not balanced ; the reform focuses on the improvement of service quality, but the distribution of objectives varies greatly. a small number of high-intensity special documents, the overall control capacity is low ; each cross-dimension analysis shows different degrees of mismatch and structural imbalance. It is recommended to improve the internal structure of the policy and enhance the balance of the use of policy tools ; give full play to the policy goal-strength synergy effect and improve the compatibility of all aspects of reform needs ; break the institutional factors that restrict the improvement of the policy system and fundamentally promote reform and development.

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  • 收稿日期:2022-09-23
  • 最后修改日期:2022-10-15
  • 录用日期:2022-10-26
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