医保扶贫政策效力评价及相对贫困时期医保防贫政策优化研究——基于PMC指数模型  

Effectiveness evaluation of medical insurance policy for poverty alleviation and the optimization of medical insurance policy for poverty alleviation in a relative poverty period—based on PMC-Index model

作　　者：郑先平[1,2] 李凤红 刘霞[1] 钟杰 刘雅[1] ZHENG Xianping;LI Fenghong;LIU Xia;ZHONG Jie;LIU Ya(Research Center of Health Management and Policy Development,Jiangxi University of Chinese Medicine,Nanchang Jiangxi 330004,China;Nankai Research Center for Health Economics and Medical Insurance,Tianjin 300350,China)

机构地区：[1]江西中医药大学医药卫生管理与政策发展研究中心,江西南昌330004 [2]南开大学医疗保障与卫生经济发展研究中心,天津300350

出　　处：《卫生软科学》2024年第2期80-84,共5页Soft Science of Health

基　　金：国家自然科学基金资助(72064023);江西省中医药科技计划一般项目(2020D002);江西中医药大学2023年度研究生科研训练计划项目。

摘　　要：[目的]对我国医保扶贫政策文本进行量化评价,为进一步优化与完善相对贫困阶段医保政策、巩固医保脱贫攻坚成果、构建长效化医疗保障防贫抑贫长效机制提供决策参考。[方法]基于2018-2021年我国具有代表性的9项医保扶贫政策文本,运用文本挖掘法,建立PMC指数评价模型并进行量化评价。[结果]9项政策中,PMC指数的计算结果为P7<P9<P2<P6<P8<P5<P1<P4<P3,其中6项为优秀政策,3项为可接受政策。[结论]我国医保扶贫政策覆盖面较宽,但在政策针对性、持续性及协同性等方面尚有欠缺,建议今后政策制定或改进时,应在保持政策总体稳定的基础上,进一步关注政策对象变化及政策目标实现路径,重点探索完善医保防贫抑贫长效机制。Objective This paper quantitatively evaluates the text of China s medical insurance policy for poverty alleviation,and provides decision-making references for further improving the medical insurance policy in a relative poverty period,consolidating the achievements of medical insurance for poverty alleviation,and constructing a long-term mechanism of medical security to prevent poverty.Methods Based on the nine representative texts of medical insurance policies for poverty alleviation in China from 2018 to 2021,the PMC-Index evaluation model was established and quantitative evaluation was carried out by using the text mining method.Results Among the nine policies,the PMC-Index was calculated as P7<P9<P2<P6<P8<P5<P1<P4<P3,of which six were excellent policies and three were acceptable policies.Conclusions The coverage of China s medical insurance policy for poverty alleviation is relatively wide,but there are still shortcomings in policy pertinence,sustainability and coordination.It is suggested that in future policy formulation or improvement,further attention should be paid to the change of policy objects and the path to achieve policy objectives on the basis of maintaining the overall stability of the policy,with a focus on improving the long-term mechanism of preventing poverty in the medical insurance system.

关 键 词：医疗保险 减贫防贫 政策评价 PMC指数模型 

分 类 号：F323.8[经济管理—产业经济] F842.6[医药卫生—卫生事业管理] R197.1[医药卫生—公共卫生与预防医学]