ObjectiveTo explore effective evaluation tools as well as systems of medical service capability related to total payment control of medical insurance.
MethodsCombining references and using the Delphi method, the evaluation indicators of total payment control of medical insurance were screened and identified. Then, based on analytic hierarchy process, a weight questionnaire was designed and weighted coefficients of all-level indicators were also calculated.
ResultsWe proposed a mathematical model to evaluate medical service capability related to total payment control of medical insurance using three types of primary evaluation indicators and seventeen types of secondary evaluation indicators with their weighted coefficients.
ConclusionThe establishment of the evaluation systems of medical service capability in medical institutions could objectively reflect medical service capability to some extent, and provide references on total payment control of medical insurance for medical insurance agencies.
