Practical Analysis on Establishing the Control Model of Medical Insurance in Public Hospital Internal Operation Based on Utility Theory / 中国卫生经济

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.