通讯作者: 陈文, wenchen@fudan.edu.cn

DOI：10.12201/bmr.202206.00012

Development and application of inclusive commercial medical insurance development Index

• 摘要：目的：研制我国普惠型商业医疗保险的发展指数，对不同保险方案的发展现况进行评估。方法：纳入全国正在实施中的全部113种普惠型商保，进行方案汇总和数据收集，综合采用文献查阅、专家咨询和描述性分析方法，形成指标体系并构建发展指数，并进行信效度检验。结果：依据保险理论和全民健康覆盖理论框架，从保障能力和保障水平两个评价维度对普惠型商保进行评价，并设定筹资适应性、风险共担能力、持续发展能力、广度、宽度、深度6个一级指标和14个二级指标，信度和效度良好；借鉴人类发展指数的测算方法，构建我国普惠型商保的保障能力指数、保障水平指数和综合发展指数并应用于实际评价。结论：发展指数适用于普惠型商保的综合评价和比较，评价结果为不同发展类型的普惠型商保发展提供指导。

  关键词： 普惠型商业医疗保险; 发展指数; 评价

   

  Abstract: Objective: To develop a development index of inclusive commercial medical insurance (ICMI) in China, and to evaluate the development status of different insurance plans. Methods: 113 inclusive commercial insurances in China were included to collect their policy and related data by comprehensively adopting literature review, expert consultation and descriptive analysis to establish the development index and examine credibility and validity. Results: According to the insurance theory and the theoretical framework of Universal Health Coverage proposed by the World Health Organization, this study constructed the index system covering two major dimensions of the operation capacity and risk protection level of ICMI plans, which were further subdivided into contribution adaptability, risk-pooling level and sustainable development, insurance breadth, width and depth as first-level indicators and 14 following second-level indicators. The reliability and validity had been proven to be acceptable. In the light of the Human Development Index, operation capacity index, risk protection index and comprehensive development index of inclusive commercial insurance were constructed and applied to the evaluation of 113 plans. Conclusion: The development index is suitable for the comprehensive evaluation and comparison of IMCI, and the evaluation results can provide guidance for the development of ICMI in different development status.

  Key words: inclusive commercial medical insurance; development index; evaluation

  提交时间：2022-06-16

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2022-02-15	bmr.202206.00012V1	下载

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