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中国的医疗保险基金监管旨在实现什么目标? 基于国家一级政策的定量分析
Jinpeng Xu1, Feier Cheng1, Xinyan Jiang1
1School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China.
BMC health services research
|December 17, 2025
概括
中国的医疗保险基金监管优先考虑基金安全,预防欺诈和公民权利. 这些目标相互关联,形成了有效的治理和评估框架的五个关键类别.
科学领域:
- 卫生政策和管理卫生政策和管理
- 公共卫生 公共卫生
- 社会科学 社会科学 社会科学
背景情况:
- 监管目标对医疗保险基金管理策略及其有效性产生了重大影响.
- 了解中国医疗保险基金监管的多方面的目标是必不可少的.
研究的目的:
- 确定中国医疗保险基金监管的不同目标.
- 分析这些监管目标之间的等级结构和相互关系.
主要方法:
- 分析了133个国家级政策,涉及到中国医疗保险基金监管目标.
- 使用频率排名,社交网络分析,Ochiai系数,聚类分析和多维缩放来检查目标层次和接近性.
主要成果:
- 基金安全成为首要目标 (11.01%),其次是打击保险欺诈 (8.55%) 和保护公民权利 (6.38%).
- 效率和经济目标优先于社会参与和正义等以公众为导向的目标.
- 在公平和正义之间发现了最强的相关性 (r=0.602),表明了显著的相互依赖.
结论:
- 中国的医疗保险基金监管包括着重于基金安全,预防欺诈和维护公民利益的相互关联的目标.
- 这些目标可以分为五个类别:公平,公民,效率,管理和社会福利.
- 调查结果为管理目标冲突和开发监管评估框架提供经验支持.
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