Research on the influencing factors of capacity enhancement of medical insurance management personnel in public hospitals:Based on the DEMATEL-ISM-MICMAC method
10.3969/j.issn.1674-2982.2025.09.006
- VernacularTitle:公立医院医保管理人员能力提升影响因素研究
- Author:
Zi-jian TANG
1
;
Bing LIANG
1
;
Ping-hua ZHU
1
;
Jing-yi HUANG
1
Author Information
1. 广西医科大学人文社会科学学院 广西 南宁 530021
- Publication Type:Journal Article
- Keywords:
Public hospitals;
Medical insurance management personnel;
Capacity improvement;
Decision-Making Trial and Evaluation Laboratory(DEMATEL);
Interpretive Structure Modeling(ISM);
Matrices Impacts Croises-Mul-tiplication Appliance Classement(MICMAC)
- From:
Chinese Journal of Health Policy
2025;18(9):39-47
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the key factors,hierarchical structure and internal action paths that affect the ability improvement of medical insurance management personnel in public hospitals,and to provide theoretical basis and practical reference for strengthening the construction of medical insurance management talent teams in hospitals.Methods:Through the mutual verification of literature analysis,policy interpretation and interview results,an index system of influencing factors for the ability improvement of medical insurance management personnel in public hospitals was constructed.A hybrid method combining DEMATEL-ISM-MICMAC was adopted to define the relationships,divide the levels and conduct driving force-dependence analysis of the influencing factors.Results:There are a total of 12 key factors influencing the ability improvement of medical insurance management personnel in public hospitals.Through the ISM model,these influencing factors can be classified into four levels:surface factors,intermediate factors,deep factors,and essential factors.With the help of MICMAC analysis,it can be classified into the spontaneous factor group of"low driving force-low dependence",the independent factor group of"high driving force-low dependence"and the dependent factor group of"low driving force-high dependence".Conclusion:Policy interpretation and knowledge reserve are the fundamental driving factors for ability improvement;Professional ethics and responsibilities are the deep-seated supporting factors of the ability system.The regulatory capacity of medical insurance funds is a key outcome and performance manifestation.
