Practical Analysis on Establishing the Control Model of Medical Insurance in Public Hospital Internal Operation Based on Utility Theory
10.7664/CHE20140709
- VernacularTitle:构建公立医院内部医保基金控制模型的实践研究
- Author:
Guogang LIU
;
Erwei ZHENG
;
Songtao QU
- Publication Type:Journal Article
- Keywords:
medical insurance;
internal controls;
information asymmetry;
utility theory
- From:
Chinese Health Economics
2014;(7):30-32
- CountryChina
- Language:Chinese
-
Abstract:
To establish the control model of medical insurance in hospitals, so as to improve the effectiveness of internal operation for medical insurance fund. Methods: Using the utility theory to establish the control model, with which the medical service provider is individual rationality constraints and incentive compatibility constraint. Results: The bonus coefficient and punishment coefficient can be calculated by means of evolutionary programming. Conclusion: The control model of hospital internal medical insurance fund is useful in controlling the medical insurance expense, it also provides the guidance and references for performance management and internal operation.
