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34家医院医保精细化管理案例的定性比较
引用本文:何紫棠刘晓坤曾旖旎刘庭芳孙学勤荣英男赵鹏宇李春厚.34家医院医保精细化管理案例的定性比较[J].中国卫生质量管理,2022,0(4):042-45.
作者姓名:何紫棠刘晓坤曾旖旎刘庭芳孙学勤荣英男赵鹏宇李春厚
作者单位:北京协和医院
摘    要:目的探究实现我国医院医保精细化管理的不同路径。方法采用模糊集定性比较分析方法(fsQCA)对34家医院医保精细化管理案例进行组态分析。结果路径一:组织建设+制度建设+创新模式建设(边缘条件);路径二:制度建设+创新模式建设;路径三:组织建设+信息化建设;路径四:信息化建设+创新模式建设。结论我国医院医保精细化管理实现路径可分为传统驱动型、创新技术驱动型和综合驱动型3种模式。医院可多元性选择,进一步探索医保精细化管理的现实路径。

关 键 词:模糊集定性比较分析方法  医院医保  精细化管理  管理路径

Delicacy Management Case of Medical Insurance: Qualitative Comparative Analysis Based on 34 Hospitals
HE Zitang,LIU Xiaokun,ZENG Yini.Delicacy Management Case of Medical Insurance: Qualitative Comparative Analysis Based on 34 Hospitals[J].Chinese Health Quality Management,2022,0(4):042-45.
Authors:HE Zitang  LIU Xiaokun  ZENG Yini
Affiliation:Peking Union Medical College Hospital
Abstract:ObjectiveTo explore different ways for realizing the delicacy management of medical insurance in hospitals in China.Methods The method of fuzzy set Qualitative Comparative Analysis (fsQCA) was used for configuration analysis of delicacy management cases of medical insurance in 34 hospitals. ResultsPath 1: organization construction plus institution construction plus innovation mode construction (edge condition). Path 2: institution construction plus innovation mode construction. Path 3: organization construction plus information construction. Path 4: information construction plus innovation mode construction.Conclusion The realization path of hospital medical insurance delicacy management in China can be divided into three modes: traditional driven mode, innovative technology-driven mode and comprehensive driven mode. Hospitals can make diversified choices and further explore the realization path of medical insurance delicacy management.
Keywords:fuzzy set Qualitative Comparative Analysis(fsQCA)  Hospital Medical Insurance  Delicacy Management  Management Path
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