中国农村卫生事业管理2025，Vol.45Issue(3)：170-176,7.DOI:10.19955/j.cnki.1005-5916.2025.03.003
大数据价值链视角下紧密型县域医共体医保总额测算指标体系构建研究
Construction of the index system for calculating the total amount of medical insurance in a compact county medical community from the perspective of big data value chain
摘要
Abstract
Objective To construct an indicator system for calculating the total amount of medical insur-ance for a compact county medical community from the perspective of big data value chain.Methods The collab-orative governance theory and the theoretical model of health service utilization behavior were integrated,and risk factors were screened based on literature research.Two rounds of expert consultation were conducted to construct an indicator system for calculating the total amount of medical insurance for a compact county medical community.Results This study finally established an indicator system which consisted of 3 first-level indicators,13 second-level indicators,and 50 third-level indicators.Among them,policy factors in the first-level indicators had the lar-gest weight value compared with individual factors and regional factors.The weight of service demand and utiliza-tion ranked first in the second-level indicators,and the weight of medical expenses in the third-level indicators was the largest.Conclusions Policy factors occupy a dominant position in the indicator system.We should attach im-portance to the dominant position of policy factors,give play to the leading role of the government,improve the medical insurance management mechanism,and enhance the fairness and efficiency of resource allocation within the medical community.关键词
大数据价值链/协同治理/紧密型县域医共体/总额测算/风险调整/指标体系Key words
Big data value chain/Collaborative governance/Compact county-level medical community/Risk adjustment/indicator system分类
预防医学引用本文复制引用
苏岱,胡莹..大数据价值链视角下紧密型县域医共体医保总额测算指标体系构建研究[J].中国农村卫生事业管理,2025,45(3):170-176,7.基金项目
国家自然科学基金青年科学基金项目(72304194) （72304194）
北京市教育委员会科研计划项目(KM202310025026). （KM202310025026）
