效率导向抑或民众满意?——基于因子分析的新型农村合作医疗基金运行绩效指标体系构建与综合评价  

Is Efficiency Oriented or is the Public Satisfied?——Construction and Comprehensive Evaluation of the New Rural Cooperative Medical Fund Operation Performance Index System Based on Factor Analysis

作　　者：何文盛[1] 李德霞 黄雪松 唐序康 He Wensheng;Li Dexia;Huang Xuesong;Tang Xukang(School of Management,Lanzhou University, Lanzhou 73000;Human Resources and Social Security Bureau,Shanzhou District, Sanmenxia 472000)

机构地区：[1]兰州大学管理学院,教授博士生导师兰州730000 [2]三门峡陕州区人社局,科员三门峡472000

出　　处：《中国行政管理》2018年第6期108-115,共8页Chinese Public Administration

基　　金：中央高校基本业务费预算绩效管理创新团队项目(编号:17LZUJBWTD006);中央高校基本科研业务费专项基金项目"一带一路"沿线国家地方政府治理能力比较研究(编号:15LZUJBWZX012);国家自然科学基金重点项目"政府职能转变背景下绩效管理研究"(编号:71433005)

摘　　要：本文针对当前我国新农合基金绩效评价中的突出问题,以基本公共价值为取向通过新农合基金对于农民群众产生的实质性影响及满意度视角,依据逻辑模型(投入、过程、产出和效益)和新公共管理"效率、效果、经济、公平"的"4E"原则,开发出一套科学有效且具有较强针对性和操作性的新农合基金运行绩效评价指标体系,基于该指标体系并结合因子分析法对甘肃省14个市(州)的新农合基金运行绩效做出综合评价。数据分析结果表明,构建的新型农村合作医疗基金绩效评价指标体系有较强的适用性,对甘肃省14个市州进行的绩效评价结论与实际较为吻合。本文发现,当前我国新农合基金绩效评价过于突出对基金运行效率的追求,忽视了农民群众的满意度。未来在新农合基金的管理模式、路径、技术方法上仍存在较大提升空间。同时,新农合基金运行在很大程度上受到区域差异和综合经济发展水平的影响,被评估的甘肃省各市州之间新农合基金的运行效果存在明显差异。从新农合基金运行来看,各级政府投入不足,基金筹资结构不合理,农民参合受益水平较低、医疗资源使用效率低等问题依然较为集中。本文建议,为了提高我国新农合基金的实际绩效,一是要明确新型农村合作医疗基金的公共产品属性,以结果导向而非效率导向做好顶层设计和管理方案;二是要立足区域经济发展水平,通过加大政府财政投入,稳步提升财政补助标准,优化基金筹资结构,激活基金利益相关者的活力与积极性,完善基金管理体系,促进区域内医疗卫生资源合理配置;三是要加强新农合基金的全过程监管和产出结果评价,确保提高基金实际补偿水平,加快提升新农合基金管理机构内部管理能力的现代化。Based on the logical model（input, process, output, and benefits）, and the ＂4E＂ principleof ＂efficiency, effectiveness, economy, and fairness＂ of the new public management, thispaper developed a set of scientific, effective and highlytargeted and operational performance evaluation indicators system for the New Rural Cooperative Medical Fund. The system combined with the factor analysis method to make a comprehensive evaluation of theperformance of the New Rural Cooperative Medical Fund operation in 14 cities（states） of Gansu Province. The data analysis results show that the New Rural Cooperative Medical Fund performance evaluation index system has strong applicability, and the conclusions of the performance evaluation of the 14 cities and counties in Gansu Province are in goodagreement with the actual situation. This paper finds that the performance evaluation of China＇s New Rural Cooperative Medical Fund is too prominent for the pursuit of fund operationefficiency, andneglects thesatisfaction of farmers. In the future, there will still be much room for improvement in the management mode, path and technology of the New Rural Cooperative Medical Fund. At the same time, the operation of the New Rural Cooperative Medical Fund is affected to a large extent by the regional differences and the level of comprehensive economic development. There are significant differences in the operational effectiveness of the New Rural Cooperative Medical Fund between the cities andcounties assessed in Gansu Province. Fromthe perspective of the operation of the New Rural Cooperative Medical Fund, the lack of government investment at all levels, the unreasonable fund-raising structure, the low level of farmers＇ participation and the inefficient use ofmedical resources are still relatively concentrated. This paper suggests that in order to improve the actual performance of China＇s New Rural Cooperative Medical Fund, firstly, itis necessary to clarify the public product attributes of the New Rural Cooperative Medical

关 键 词：新农合基金 因子分析 公共价值 治理能力 绩效评价 

分 类 号：D035[政治法律—政治学]