复杂自适应系统视角下大病医保理论模型、效果评价及优化策略仿真研究

本研究以“大病医保的理论研究—实施效果评价—问题诊断与制度成因分析—政策仿真与策略优化”这一系统的链条式思维脉络作为核心研究框架。通过对国内外大病的概念内涵、界定标准、大病医保制度理论模型构建进行探索性的理论研究，探讨我国大病医保在运行初期实现人口宽度全民覆盖的基本目标后，下一阶段，制度关键参数的合理设计方案与有效运行的实现模式；通过构建评价指标体系，对大病医保制度实施效果进行多维度、多视角的现况把脉与问题诊断，并基于定量和定性研究结果对锁定的薄弱环节进行深度制度成因分析；基于复杂自适应系统理论，采用公共政策领域先进的Multi-Agent仿真技术构建大病医保制度优化策略模型，通过概念建模、数学建模及VV&A检验体系校验，集数学、统计学与计量经济学等多学科方法，实现对大病医保优化这一复杂政策问题进行科学化的表征与有用性的仿真，为决策者提供可操作性且量化的决策依据。

In this study, the chain thinking vein, “theoretical research on the framework of major disease medical health insurance scheme—effect evaluation—problem diagnosis and institutional cause analysis—optimization model construction and policy simulation” ,will be taken as the core research framework. This study will make a systematic exploratory theoretical research on the concept, the definition standard of the major disease and the construction of theoretical model of major medical health insurance scheme. Meanwhile, it will also discuss the reasonable design and realization mode of the structural factors and key parameter of the major disease medical health insurance scheme, after the achievement of the basic goal of universal coverage of critical disease medical insurance. By constructing the evaluation index system, this study will make a diagnosis on current situation of implementation effect of the major disease medical health insurance scheme based on a multi-dimensional and multi-perspective view. Based on the quantitative and qualitative research results, this study will make an in-depth institutional analysis on the focused weak links. Based on the theory of complex adaptive system, this study will adopt the advanced agent simulation model of public policy field to construct the optimal strategy model of major disease medical health insurance scheme. Through the concept modeling, mathematical modeling and VV&A test system verification; this study will achieve the scientific representation of policy issues and usefulness of the simulation, finally to provide the scientific and quantitative evidence for the policy makers.