新农合管理效果评价指标体系研究-西部农村卫生发展研究中心-四川大学.PDF

Methodology Chin J Evid-based Med 2014, 14(1): 110-114 新农合管理效果评价指标体系研究 1,2 1* 周晓媛   毛正中 1. 四川大学华西公共卫生学院（成都 610041 ）；2. 四川大学西部农村卫生发展研究中心（成都 610041 ） 摘要  目的 为如何评价新农合不同管理模式的管理效果建立一套较为科学的评价指标体系。方法 通过文 献复习，初步筛选出新农合管理效果评价指标，进一步通过两轮Delphi 法对指标进行必要性评价，建立一级指标 和二级指标，进而运用多维度效用理论计算一级指标下各类指标的权重得分。结果 初拟出涉及管理效果评价的 指标共8 个，经过两轮专家咨询，最终建立了包含4 个一级指标（理赔率、新农合基金管理是否规范、新农合信息 是否公开、对定点医疗机构的监管）和9 个二级指标的评价指标体系，以及一级指标的权重系数和二级指标的具 体评分标准。结论 本研究初步建立了新农合管理效果评价指标体系，为下一步开展不同模式间的效果评价提供 了基础。 关键词 新农合；管理模式；管理效果；评价指标 Study on Indicators of Management Effect within NCMS ZHOU Xiao-yuan1,2, MAO Zheng-zhong1* 1. West China Public Healthy School, Sichuan University, Chengdu 610041, China; 2. Western China Centre for Rural Health Development and Research, Sichuan University, Chengdu 610041, China Abstracts Objective New Rural Cooperative Medical Systems (NCMS) has been constructed as a financial protec- tion for rural population commencing 2003. With the development of NCMS, there were quite a few management models existing across the nation. In order to assess the management alternatives, we try to explore how to set up a set of indicators to analysis management effect of different management models. Methods By literature review, we sorted all qualitative indicators into 8 types. Delphi and Multi-Attribute utility theories were applied to construct the appraisal indicators, includ- ing shaping first and second level indicators and assigning the weights for each type of indicators. Results We managed to identify the indicator system which was comprised of 4 types of first level indicators, aiming at claim, manament process, transparency and supervision on accredited hospitals. Besides, there were 9 sub-indicators. Conclusion The evaluation in- dicators are constructed for future assessment on management effect of rural health insurance. Key words New Rural Cooperative Medical System (NCMS