政策工具视角下我国基本医保门诊保障政策文本分析  

Textual Analysis of China's Basic Medical Insurance Outpatient Guarantee Policies from the Perspective of Policy Instruments

作　　者：吴敏 韩志琰[1,2] 穆晓敏 范其鹏[3] 

机构地区：[1]山东第一医科大学医疗保障学院(山东省医疗保障研究院),济南250117 [2]山东省医药卫生科技信息研究所,济南2500117 [3]山东省医疗保险基金稽核中心,济南250014

出　　处：《中国医疗保险》2023年第8期28-35,共8页China Health Insurance

摘　　要：本文构建“政策阶段—政策工具—政策主体”三维分析框架,运用政策编码分类统计以及基于社区探测算法的网络分析方法等,对110份门诊保障政策文本进行量化分析。研究发现,不同政策阶段门诊保障政策演进特点有所差异。在政策工具的选择上呈现出一定的不均衡性,更倾向于利用环境型政策工具,而供给型和需求型政策工具使用较少;各类政策工具内部亦存在结构不均衡,门诊保障政策宣传、监督管理、考核评估等次级政策工具使用较少。政策主体网络构型由“大而松散”趋向于“精简紧缩”。建议强化门诊保障政策顶层设计,确保改革稳妥推进;均衡配置门诊保障政策工具,促进协同作用发挥;优化政策主体协作,确保有效沟通合作。This paper constructs a three-dimensional analytical framework encompassing policy phases,policy instruments,and policy actors,and quantitatively analyzes 110 outpatient guarantee policy texts with policy coding classification statistics and network analysis methods based on community detection algorithm.The research reveals distinct characteristics in the evolution of outpatient guarantee policies across different policy phases.Notable imbalances are observed in the selection of policy instruments,with a leaning toward environmental policy tools and relatively fewer application of supply-side and demand-side policy instruments.Additionally,an internal structural imbalance is identified within various categories of policy instruments,indicating limited utilization of secondary tools such as the policy promotion,supervision and management,and assessment and evaluation of outpatient guarantee policies.The configuration of the policy actor network shifts from a larger and loosely connected pattern towards a more streamlined and compact structure.This study proposes to reinforce top-level design for outpatient guarantee policies to ensure a steady and prudent reform progression.Moreover,a balanced allocation of outpatient guarantee policy instruments is recommended to enhance synergistic effect,while optimizing policy actor collaboration is essential for effective communication and cooperation.

关 键 词：门诊保障 政策工具 政策文本分析 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]