Development of a Network-Based Operation Model for Committees of Sub-District Health Insurance Funds

Abstract

     The objectives of this study were to analyze the network structure, synthesize practical lessons and develop a network-based operation model for the committees of sub-district health insurance funds. The study was divided into four steps. In the first step, the network structure in 33 funds was analyzed using questionnaire data, the NetMiner program and cluster analysis statistics. The results revealed that the general structures were low density, high centrality and closeness, with few isolation structures or structural holes. The structures of all funds were able to be divided into two groups based on high and low network structure characteristics. In the second step, lessons from 10 funds were distilled and synthesized using group interviews based on a semi-structured in-depth interview form and content analysis. The results revealed lessons learned covering both similar and different issues. Similar lessons were related to the process of the National Health Security Office. However, different lessons were related to activities that the funds set themselves. In the third step, a network-based operation model was developed. Two models of network-based operation were developed: a participation model, and a monitoring and control model. In the fourth step, models by five experts were verified. The results revealed that these models covered the essential factors and allowable practices in the funds. Based on the findings, it was proposed that the National Health Security Office should apply these models to develop fund operations, and fund committees should select the model that best suits their context.