Research On The Medical Insurance Credit Evaluation Index System Of Designated Medical Institutions

The medical insurance credit evaluation of designated medical institutions is to construct a more targeted and feasible medical insurance credit evaluation of designated medical institutions through research to ensure the work efficiency of the sustainable development of medical insurance.However,China currently does not have a clear and definite evaluation index system.Therefore,this study constructed a set of medical insurance credit evaluation index system for designated medical institutions to provide reference for government departments and regulatory agencies.In this study,through the literature research method and interview method,combined with the latest policies,medical insurance service agreements,and the existing designated medical institution credit evaluation system in individual cities,the medical insurance credit evaluation index system of designated medical institutions was preliminarily selected.Two rounds of expert consultation questionnaires screen the indicators,and the analytic hierarchy process and proportional distribution method are used to determine the weight of each indicator.The questionnaire response rate was 100% and 93.3%,and the expert authority coefficient was 0.855.The overall coordination coefficient in the first round was 0.254,and the overall coordination coefficient in the second round was 0.290,and the p-values were all less than 0.05,which was statistically significant.The most innovative part of this article is the integration of the characteristics of the medical institution industry,the rules of medical insurance operation and the elements of credit evaluation.The index selection combines the commonality of credit evaluation elements and the particularity of medical insurance.Finally,6 first-level indicators,32 second-level indicators,and 57third-level indicators is constructed.Figure 4;Table 39;Reference 41.