基于PMC指数模型的中医医保支付政策量化评价研究

裴中阳; 闫莹莹; 杨婕; 胡安霞; 闫娟娟; 郭华伟

doi:10.19546/j.issn.1674-3830.2022.12.011

中国医疗保险 ›› 2022, Vol. 0 ›› Issue (12) : 61-68. DOI: 10.19546/j.issn.1674-3830.2022.12.011

观察思考

基于PMC指数模型的中医医保支付政策量化评价研究

裴中阳¹, 闫莹莹², 杨婕¹, 胡安霞¹, 闫娟娟¹, 郭华伟³

作者信息 +

Research on Quantitative Evaluation of Medical Insurance Payment Policy of Traditional Chinese Medicine based on PMC Index Model

Author information +

文章历史 +

摘要

目的: 以中医医保支付相关政策为研究对象进行政策评价,识别政策不足,探索中医医保支付政策特色,为后续政策的制定与完善提供参考。方法: 检索2013年3月至2022年3月国家层面中医医保支付相关政策文件,对政策文本进行语义网络分析,建立PMC指数评价模型,通过10个一级变量和45个二级变量对3项代表性政策进行量化评价分析。结果: 32份政策中,优秀级8项,良好级22项,可接受级2项,PMC指数均值为7.224;3份代表政策样本的各项指标差异较明显,主要体现在发布机构、政策内容、激励措施方面需要进一步调整与优化。结论: 强化政策协同作用,建立相关配套措施,探索适合中医发展的医保支付政策。

Abstract

Objective: The paper conducts policy evaluation based on policies of TCM insurance payment, in order to identify policy deficiencies, explore the characteristics of TCM insurance payment policies, provide reference for the formulation, improvement of follow-up policies. Methods: The relevant policy documents of TCM insurance payment from March2013to March2022were retrieved, analyzed by semantic network. The PMC index evaluation model with10primary variables, 45secondary variables was established, 3representative policies were quantitatively evaluated, analyzed. Results: Among the32policies, 8were excellent, 22were good, 2were acceptable, the average value of the PMC index was7.224. The indicators of the3sample policies were obviously different. The policy issuing agencies, policy content, incentive measures need to be adjusted, optimized. Conclusion: We should strengthen the collaboration of policies, take supporting measures, explore medical insurance payment policies suitable for the development of TCM

导出引用

裴中阳, 闫莹莹, 杨婕, 胡安霞, 闫娟娟, 郭华伟. 基于PMC指数模型的中医医保支付政策量化评价研究[J]. 中国医疗保险. 2022, 0(12): 61-68 https://doi.org/10.19546/j.issn.1674-3830.2022.12.011

Research on Quantitative Evaluation of Medical Insurance Payment Policy of Traditional Chinese Medicine based on PMC Index Model[J]. China Health Insurance. 2022, 0(12): 61-68 https://doi.org/10.19546/j.issn.1674-3830.2022.12.011

中图分类号： F840.684 C913.7

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