Research on the path of digital transformation of medical insurance management services: Fuzzy-set Qualitative Comparative Analysis Based on 22 Cases

Corresponding author: baihanbin

DOI: 10.12201/bmr.202407.00032

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  Abstract: Objective: This study empirically analyzes the multiple driving paths for digital transformation of medical insurance management services, in order to provide useful references for improving the quality and efficiency of medical insurance management services. Methods: Based on TOE theory, the theoretical analysis framework of the influencing factors of the digital transformation of medical insurance management services was constructed. 22 typical cases related to the digitalization of medical insurance management services in China from 2022 to 2023 were selected as analysis samples, and six conditional variables were selected from the three dimensions of technology, organization and environment to analyze their impact on the digital transformation of medical insurance management services by using the fuzzy-sets qualitative comparative analysis method. Results: A single antecedent condition does not constitute a necessary condition for promoting digital transformation, and four configurations that can promote digital transformation are found, and three feasible paths are summarized based on the research results: “policy support-technology driven” (R1+R3), “resource endowment-system collaboration” (R2), and “limited resources- pioneering development” (R4). Conclusion: The path of digital transformation of medical insurance management services is heterogeneous, and the linkage and combination of different conditional variables will form different transformation paths.

  Key words: Medical insurance management services; Digital transformation; Fuzzy-set qualitative comparative analysis; TOE framework

  Submit time: 15 July 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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