基于灰色综合评价法的北京市医疗保障高质量发展指标体系评价实证研究  

An empirical study on the evaluation of the index system of high-quality development of medical security in Beijing based on the grey comprehensive evaluation method

作　　者：赵宁 孙力光[2] 高广颖 韩优莉[1] 杨佳 ZHAO Ning;SUN Li-guang;GAO Guang-ying;HAN You-li;YANG Jia(School of Public Health,Capital Medical University,Beijing 100069,China;Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]首都医科大学,北京100069

出　　处：《中国卫生政策研究》2023年第6期20-28,共9页Chinese Journal of Health Policy

基　　金：国家自然科学基金面上项目(72274129);北京市社会科学基金决策咨询项目(21JCB114)。

摘　　要：目的:基于医保新发展理念,以国家宏观政策为导向,结合北京市医疗保障改革工作重点,构建医保高质量发展评价指标体系,评价2018—2021年北京市医疗保障高质量发展状况。方法:运用描述性分析结合灰色综合评价方法,从参保公平、管理服务、基金监管、社会协同、运行效果五个维度进行分析。结果:整体上,北京市2018—2021年医保高质量发展水平呈现稳步提升趋势,各维度指标取值逐步向最优值靠近。结论:评价指标体系和评价方法具有科学性与适用性。北京市医保发展水平不断提高,但发展不稳定和不平衡问题显现;医保制度体现一定公平性,应保尽保与重复参保问题仍存在;医保基金平稳可持续运行,制度间存在筹资待遇差距;医保基金监管机制逐步健全,监管方式亟需创新优化。Objective:Based on the new development concept of medical insurance,guided by national macro policies and combined with priorities of medical insurance policy in Beijing,an evaluation index system for the high-quality development of medical insurance is constructed to evaluate the quality development of medical insurance in Beijing from 2018—2021.Methods:Descriptive analysis combined with the gray comprehensive evaluation method was used to analyze five dimensions:Fairness in participation,management services,fund supervision,social coordination,and operational effectiveness.Results:Overall,the level of high-quality development of medical insurance in Beijing from 2018—2021 shows a trend of steady improvement,and the index values of all dimensions gradually approach the optimal values.Conclusion:The evaluation index system and evaluation method have a certain degree of scientificity and applicability.The level of medical insurance in Beijing has been continuously improved,yet the problems of unstable and unbalanced development have emerged.There is certain fairness in the medical insurance system,but not all who should take part are included in the insurance and the problem of duplicate enrollment still exists.The medical insurance fund operates smoothly and sustainably,but the gap of funding treatment exists between systems.The regulatory mechanism of medical insurance fund is gradually improved,yet its methods need to be innovated and optimized.

关 键 词：医疗保障 高质量发展 灰色综合评价法 

分 类 号：R197[医药卫生—卫生事业管理]