普惠保参与罕见病保障的利益相关者分析与政策建议  

Stakeholder Analysis and Policy Recommendations for Inclusive Health Insurance Participation in Rare Disease Health Care Coverage

作　　者：冯俊超 张海琴 李顺平 Feng Junchao;Zhang Haiqin;Li Shunping(Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan,250012,China;不详)

机构地区：[1]山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,济南250012 [2]国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),济南250012 [3]山东大学健康偏好研究中心,济南250012 [4]广西壮族自治区医学科学信息研究所卫生健康政策研究室,南宁530022

出　　处：《中国卫生经济》2023年第12期23-27,共5页Chinese Health Economics

基　　金：国家自然科学基金面上项目(72174110)。

摘　　要：目的:基于利益相关者视角,对普惠保参与罕见病保障的利益相关者进行识别,对存在的问题予以分析。方法:使用文献综述法和米切尔评分法进行利益相关者的识别、分型和关系分析,对已明确的主要利益相关者进行定性访谈,探究其在参与普惠保过程中的诉求、定位与阻碍因素。结果:医疗保障局、银保监会与主承保公司为“确定型利益相关者”,对普惠保发展影响最大。编码最终形成了63条概念,并从利益诉求、角色、优势、难点和行为策略5大范畴对各利益相关者进行分析和阐述。结论:各利益相关者之间诉求存在差异,职责不够明晰,有效协同程度不够。Objective:To conduct stakeholder identification and problem analysis of inclusive health insurance participation in rare disease coverage based on the stakeholder perspective.Methods:A literature review and a Mitchell scale were used to identify,categorize,and analyze the relationship among the stakeholders,and qualitative interviews were conducted with identified stakeholders to explore their demands,positioning,and barriers to participation in inclusive health insurance.Results:The Healthcare Security Ad-ministration,Banking and Insurance Regulatory Commission,and the primary insurer were the most influential“identified stakehold-ers”in the development of inclusive health insurance.A total of 63 concepts were coded,and the stakeholders were analyzed and de-scribed in categories of claims,roles,strengths,difficulties,and behavioral strategies.Conclusion:There were differences in the de-mands of the stakeholders,lack of clarity of roles,and lack of effective synergy.

关 键 词：普惠保 罕见病 利益相关者 医疗保障 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F840.625[经济管理—保险]