上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (2): 128-.doi: 10.3969/j.issn.1674-8115.2011.02.002

• 专题报道（医改效果评估） • 上一篇    下一篇

医疗保障体系改革效果评估指标体系的研究

李妍婷1, 赵 明1,2, 丁 蕾1, 陆 琳1, 马 进1   

  1. 1.上海交通大学 公共卫生学院, 上海 200025；2.上海申康医院发展中心, 上海 200041
  • 出版日期:2011-02-28 发布日期:2011-03-01
  • 通讯作者: 马 进, 电子信箱: majin@shsmu.edu.cn。
  • 作者简介:李妍婷（1988—）, 女, 硕士生；电子信箱: hightingli@gmail.com。
  • 基金资助:

    国家发展和改革委员会社会发展司项目（2009HR01）

Study on evaluation indicators of medical security system reform

LI Yan-ting1, ZHAO Ming1,2, DING Lei1, LU Lin1, MA Jin1   

  1. 1.School of Public Health, Shanghai Jiaotong University, Shanghai 200025, China；2.Shanghai Shenkang Hospital Development Center, Shanghai 200041, China
  • Online:2011-02-28 Published:2011-03-01
  • Supported by:

    Foundation from National Development and Reform Commission of China, 2009HR01

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摘要：

目的 制定出适合评估新医改中医疗保障体系改革效果的指标体系，并设定有时间限制的、适合不同地区发展水平的评价标准。方法 运用平衡计分卡的模型，在政府维度、群众维度、内部运营维度和革新与学习维度建立新医疗保障体系的评估指标，并运用德尔菲专家咨询对指标进行打分筛选，征询专家对评价标准的意见和建议。结果 最终筛选确定12个医疗保障体系的指标（城镇居民医疗保险的覆盖率、新型农村合作医疗覆盖率、破产企业退休人员参保率、农民工参保率、城乡低保家庭成员、五保户参保率、参合农民医疗费用减免水平、城市居民就医致贫率、农民就医致贫率、新农合政府补助增长水平、城市居民医疗保险政府补助增长水平、城镇居民保险结余率、新农合获得补偿周期）及其权重，并根据专家意见给出评价建议。结论 建立了医疗保障体系改革效果评估指标体系，兼顾了政府、群众、内部运营以及革新与学习4个维度的内容，能体现医疗保障体系的改革效果，并且归纳整理了考虑时间限制和地区差异的评估标准，具有较高的参考价值。

关键词: 新医改, 医疗保障体系, 评估指标, 平衡计分卡, 德尔菲专家咨询

Abstract:

Objective To build up evaluation indicator system of China's new health reform in medical security system, and establish evaluation standards fit to different time and areas. Methods Evaluation indicators of medical security system were set up from the government dimension, public dimension, internal management dimension and innovation and learning dimension using the model of Balanced Scorecard. Evaluation indicators were screened by Delphi consultation, and advice from experts on the evaluation standards was collected. Results Twelve indicators (coverage rate of medical insurance for urban residents, coverage rate of new rural cooperative medical insurance, coverage rate of medical insurance for retirees of bankrupt enterprises, coverage rate of medical insurance for migrant workers, coverage rate of medical insurance for low-income family, fee reduction level of new medical insurance for farmers, rate of poverty due to illness for farmers, rate of poverty due to illness for urban residents, growth rate of government grants for new rural cooperative medical insurance, growth rate of government grants for urban residents, balance rate of new rural cooperative medical insurance and compensation cycle of new rural cooperative medical insurance）and weight were determined, and advice was proposed. Conclusion The established evaluation indicator system of medical security system takes the four dimensions of government, public, internal management and innovation and learning into consideration, is fit to different time and areas, and bears high value of reference.

Key words: new health reform, medical security system, evaluation indicators, Balanced Scorecard, Delphi expert consultation