摘要
基本医疗保障制度是社会保障体系的重要组成部分,欺诈骗保行为严重危害了医保基金安全。对此,文章从制度工程学中的行为管理制度设计理论出发,利用医患合谋骗保行为惩罚制度,对参保人员的行为进行分析,通过分析制度有效边界条件,提出相应的治理措施。
The basic medical security system is an important part of the social security system.The behavior of insurance fraud seriously endangers the security of medical insurance fund.In order to effectively control the medical security fraud,this paper made analysis of the behaviors of the insured with the system of punishment for doctor-patient conspired insurance fraud based on the design theory of behavior management system in the systems engineering science.Then,the corresponding measures were put forward by analyzing the effective boundary conditions of the system.
作者
陈志超
孙绍荣
CHEN Zhichao;SUN Shaorong(School of Business,University of Shanghai for Science and Technology,Shanghai 200093,China)
出处
《中国农村卫生事业管理》
2019年第9期624-629,共6页
Chinese Rural Health Service Administration
基金
国家自然科学基金项目(71771151)
关键词
医疗保障制度
骗保行为
治理
制度工程学
孙氏图
Medical insurance system
Insurance fraud
Control
Systems engineering science
Sun chart
