安徽省医疗保障信息平台的建设与评价

【作者】 苏玉林；

【导师】 姚德利；

【作者基本信息】 安徽理工大学 ， 工程管理， 2022， 硕士

【摘要】 安徽省原医保系统分散在多个部门,涉及到信息系统的任何工作,只能商请其他部门协查和解决问题,管理效率较低。安徽省要完成待遇保障、医保支付、基金监管等关键领域的改革任务,存在“医保基金收支平衡压力较大”、“三医联动改革压力较大”、“医保基金未实现精细化监管和管理”、“各市医保经办流程差异较大”、“医保数据标准不统一”等问题,原医保系统无法满足医保业务改革发展需要,同时根据国家医疗保障局统一部署,全国范围内自上而下需完成医疗保障信息平台建设,因此安徽省医疗保障信息平台的建设迫在眉睫。本文主要是对安徽省医疗保障信息平台的建设与评价进行描述。通过多种研究方法,并运用管理学、经济学等多学科知识对安徽省医疗保障信息平台建设的基本需求和安徽省医疗保障信息平台的设计及建设、应用情况及存在问题进行深入分析,最后通过多层次分析法及模糊评价法,设置科学、合理的评价指标对医疗保障信息平台的建设实施和运行效果进行评价,安徽省医疗保障信息平台建设隶属度最大为0.4386,对应的评价等级为“很满意”,评价表明,专家对安徽省医疗保障信息平台建设整体很满意,同时系统稳定性、数据可靠性、技术先进性、管理先进性等指标都处于“满意”和“很满意”的等级,项目实施达到了预期水平。通过对安徽省医疗保障信息平台建设的研究,可以让更多人了解工程管理如何在政务类、民生类、信息化类项目上进行应用,可以让政府部门设置科学、合理的评价指标,可以让政务类、民生类、信息化类项目节约资金、提高效益、缩短建设时间,减少部分由于项目管理缺陷带来的问题。图 [20] 表 [26] 参 [73]更多还原

【Abstract】 The original healthcare security information system in Anhui Province is scattered in multiple departments.Any work involving the information system can only be checked and solved with the help of other departments.The management efficiency is low.Anhui Province should basically complete the reform tasks in key areas such as treatment guarantee,healthcare security fund payment and fund supervision.There are some problems,such as "great pressure on the balance ofhealthcare security fund ","great pressure on the reform of the linkage of three medical services","failure to achieve fine supervision and management of healthcare security fund","great differences in healthcare security handling processes in various cities",and "inconsistent healthcare security data standards",The original healthcare security information system can not meet the needs of the reform and development of healthcare security business.At the same time,according to the unified deployment of the National Healthcare Security Administration,the construction of the healthcare security information platform needs to be completed nationwide from top to bottom.Therefore,the construction of the healthcare security information platform in Anhui Province is imminent.This paper focuses on the description of the construction and evaluation of the healthcare security information platform in Anhui Province.Through a variety of research methods and the use of management,economics and other multidisciplinary knowledge to analyse and design the current situation of healthcare security in Anhui Province,design,construction,application and existing problems of the healthcare security information platform are described,Finally,through multi-level analysis and fuzzy evaluation method,reasonable and scientific evaluation indexes are set to evaluate the whole healthcare security information platform,The maximum affiliation degree of Anhui healthcare security Information Platform Construction is 0.4386,and the corresponding evaluation level is "very satisfactory",which indicates that the experts are very satisfied with the operation effect of this platform.Besides,the system stability,data reliability,technical advancement and management advancement are all in the "satisfactory" and "very satisfactory" levels,and the project implementation has reached the expected level.The research of the Anhui healthcare security Information Platform Construction can help people understand how engineering management can be applied to governmental and information technology projects which are related to people’s livelihood,and enable other government departments to choose scientific and reasonable evaluation indicators to build new platforms with less costs,less problems and high efficiency,reducing some problems caused by management defects.Figure [20] Table [26] Reference [73]更多还原