中国医疗保险
中國醫療保險
중국의료보험
CHINA HEALTH INSURANCE
2014年
12期
28-30
,共3页
天津市%社会医疗保险%审核质量%综合评价%权重
天津市%社會醫療保險%審覈質量%綜閤評價%權重
천진시%사회의료보험%심핵질량%종합평개%권중
Tianjin%social medical insurance%quality audit%comprehensive evaluation%weight
本文研究评估天津市2011年20个区县5种门诊大病医疗费的审核质量及其影响因素。采用加权TOPSIS进行数据分析并分档评价。不同区县审核质量趋同，差异较小。评估值反映了不同区县的实际工作水平，医疗审核质量的提高得益于严格的管理和丰富的专业知识，地域差异不应作为提高医疗保险统筹层次的障碍。
本文研究評估天津市2011年20箇區縣5種門診大病醫療費的審覈質量及其影響因素。採用加權TOPSIS進行數據分析併分檔評價。不同區縣審覈質量趨同，差異較小。評估值反映瞭不同區縣的實際工作水平，醫療審覈質量的提高得益于嚴格的管理和豐富的專業知識，地域差異不應作為提高醫療保險統籌層次的障礙。
본문연구평고천진시2011년20개구현5충문진대병의료비적심핵질량급기영향인소。채용가권TOPSIS진행수거분석병분당평개。불동구현심핵질량추동，차이교소。평고치반영료불동구현적실제공작수평，의료심핵질량적제고득익우엄격적관리화봉부적전업지식，지역차이불응작위제고의료보험통주층차적장애。
To evaluate the audit quality of the medical cost by outpatients with serious diseases in 20 districts or counties in Tianjin municipality during 2011, and to find out the influencing factors on its dynamic development, TOPSIS were used to analyze and evaluate the data. The audit quality of all districts was similar and reflected their working capability. Attaining a higher audit quality target is depended on the strict management, and plenty of professional knowledge. Difference in economy level should not hinder the improvement of the level of overall planning in social medical insurance.
