Study Architecture Medicare Designated Medical Institutions Credit Rating Indicators

Research PurposeThe purpose of this study is to establish a set of health insurance credit rating evaluation index system which is suitable to the development status of our hospital, so as to facilitate the practical application of designated medical institutions. Setting up a system that can evaluate indicators index weight and eventually building a designated medical institutions, credit rating index system and providing scientific, standardized, standardized indicators for system in order to achieve the designated hospitals for medical insurance credit rating.Research Methods1.Document ResearchBy Reading a lot of document at home and abroad, we understood the status of domestic and foreign health insurance integrity, the common problems and related credit rating index system established, and summarized them.2. Site investigation methodThrough research we found out that the current health insurance credit evaluation approaches and collected the deficiencies in the actual evaluation process. We Collected some preliminary indicators for the establishment of designated medical institutions of the health insurance credit rating system and formed a preliminary indicators standard.3.Consulting ExpertsIn this study, we did two rounds expert consultation all together. The main purpose of the first round of expert consultation is to screen indicators, the main purpose of the second round of expert consultation is to determine the evaluation index.4.Analytic Hierarchy Process (AHP)Using the level analysis method combined with expert consultation questionnaire evaluation index weights so that a final evaluation model can be formed eventually.Results 1.We determined five major categories of evaluation indicators that with structure and hierarchy for basic management, balance sheet management, medical management, quality management, and information management, including5first-level indicators,22second-level indicators and74third-level indicators. After two rounds of expert consultation survey:the central tendency of the experts on indicators assignment was obvious. The coordination coefficient tends to increase, which shows that the experts on indicators acceptance is increasing, and indicators of screening is reasonable.2.We determined the value of the index weight at all levels. We applied AHP combined with experts’advice to build up a judgment matrix, using the Analytic Hierarchy Process yaahp0.5.3software index weight to calculate the results of expert advice. Indicators at all levels to meet the conformance requirements, draw level indicators weight assignment respectively0.2125,0.1739,0.2563,0.2189,0.1384weights of third-level indicators see the Appendix.3.We used aasic information on the selected experts to analyze the result, which indicated that experts are more authoritive, and their enthusiasm is also higher. The overall coordination of the two expert advisory coefficient were0.264,0.326the coordination coefficient chi-square test P value were all less than0.01, the second round of the coordination coefficient was higher than the first round, and the results were more desirable.4.We Calculated the Kroner Bach coefficient reliability coefficienta, and the alpha value is between0.35and0.7, which indicate the evaluation index system is very liabiliable.ConclusionsThe application of analytic hierarchy process in establishing a more complete evaluation of the designated medical institutions, health insurance credit rating system is divided into five dimensions:basic management, balance sheet management, medical management, quality management, and information management. Among them, the first-level index weight ranging from high to low are as follows:medical management0.2563, quality management0.2189, basic management0.2125, settlement management0.1739, information management0.1384.