通讯作者: 胡敏, humin@fudan.edu.cn

DOI：10.12201/bmr.202207.00025

Exploration and enlightenment of the content design of credit management for the basic medical insurance participants in China——Based on the content analysis of the text of credit management policy of 18 regions

• 摘要：目的：分析我国各地出台的涉及参保人主体的信用管理政策内容及特点，总结参保人信用行为界定范围和信用结果处理手段，为后续信用体系建设完善提供科学依据。方法：采用内容分析法，从官方网站收集2021年10月1日前出台的涉及参保人主体的信用管理政策文件，构建编码体系将政策内容归类，并统计其使用频率。结果：本文分析了符合条件的18个省市的21份信用管理政策文件，归纳出8类各地界定的参保人信用行为，包括29种具体行为，以及失信惩戒和守信激励的22种具体措施。结论：在信用管理体系的初步发展的阶段，我国各地医保参保人信用管理内容设计缺乏一致性，需要顶层设计进一步引导，逐步统一、完善医保参保人信用行为的界定范围，建立合理的守信激励和失信惩戒措施，从而建成管用、高效的信用管理体系。

  关键词： 基本医疗保险; 信用; 信用管理; 参保人

   

  Abstract: Objective: To analyze the contents and characteristics of credit management policies issued in various parts of China involving the main participant of the insured, summarize the definition scope of the credit behavior of the insured and the means of processing credit results, and provide a scientific basis for the improvement of the subsequent credit system construction. Methods: Using content analysis method, the credit management policy document involving the insured persons subject was issued by October 1, 2021 from the official website, the coding system was constructed to classify the policy content and count its frequency of use. Results: This paper analyzes the 21-point credit management policy documents of 18 eligible provinces and cities, and summarizes the credit behavior of the insured defined in 8 categories, including 29 specific acts, as well as 22 specific measures of breach of trust punishment and trustworthiness incentive. Conclusion: In the initial stage of the development of credit management system, the design of credit management content of health insurance participants in various parts of China lacks consistency, and it is necessary to further guide the top-level design, gradually unify and perfect the definition of credit behavior of medical insurance participants, establish reasonable trustworthiness incentive and breach of trust disciplinary measures, so as to build a functional and efficient credit management system.

  Key words: Basic medical insurance; Credit; Credit management; Insured

  提交时间：2022-07-11

  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	2022-01-07	bmr.202207.00025V1	下载

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