Crisp-set Qualitative Comparative Analysis Research Articles

A Relational Theory of Jihadist Affiliate Behaviour: The Case of Al Qaeda and the Islamic State

ABSTRACT Why do some AQ and IS affiliates fight one another while others avoid tension or even coordinate? While the extant theories of environment and power balancing provide inroads into such a puzzle, they overlook key relational factors shaping jihadist affiliate behaviour. In this article, I develop a relational theory of AQ-IS interactions, mapping out three avenues of pre-existing social networks: affiliate-civilian, AQ-IS affiliate and affiliate-unaffiliated rebels. Using several datasets, I examine AQ-IS relations in six regions from 2014 to 2018 with a crisp-set qualitative comparative analysis. Rival affiliates conflict less while relying on civilian support and cooperate more as off-shoots.

Conditions of Sustainable Welfare: A Cross-Case Empirical Analysis of 22 Locality-Based Welfare Systems in Decentralised Indonesia

The existing body of knowledge underpinning welfare state theory suggests that most welfare systems depend on growth. It signifies that the state–market mechanism is a prerequisite for achieving welfare. However, the current ecological crisis highlights the detrimental effects of unchecked economic growth, which often exploits human and natural resources. This phenomenon calls for a countermovement that protects society and natural resources through social and public policies. Within the domain of sustainable welfare, an argument points towards the need to gain an empirical understanding of sustainable welfare policies and gather qualitative evidence that explains the conditions and mechanisms of “better” eco-social performance. This article aims to identify conditions leading to achieving sustainable welfare outcomes and discern under which conditions sustainable welfare outcomes are attainable or fail, especially in the context of the Global South. It draws on empirical data to analyse the locality-based welfare systems of 22 villages across decentralised Indonesia using a conditions-oriented approach of the crisp-set Qualitative Comparative Analysis. The findings shed light on the institutional setting and policy mix leading to sustainable welfare outcomes in less-industrialised, informal economy-based, and highly decentralised country contexts. The evidence points to the presence of sustainable welfare outcomes when a substantial level of subsidiarity, self-governance, and meaningful community participation, and a policy mix covering basic needs, services for vulnerable groups, a functioning local economy, and innovative ecological practices are in place. While past research predominantly leans towards a statist-focused approach to sustainable welfare, this study proposes a society-focused perspective. It argues that transforming both modes of production and relational dynamics among society, state, and market in the Global South context is necessary, where an empowered society serves as a prerequisite for sustainable welfare outcomes.

The formation mechanism of primary health care team effectiveness : a qualitative comparative analysis research

BackgroundTeam-based care is an essential part of primary health care (PHC), and its team service delivery process is a systematic one involving multiple and complex influences. Research on the formation mechanism can help improve the effectiveness of primary health care teams (PHCTs).MethodsFirst, based on the Donabedian model, we explored the theoretical framework of a PHC team’s effectiveness formation mechanism. Semi-structured interviews were conducted with 23primary health care team members in Hangzhou, Zhejiang Province, China. A total of seven factors were then included as conditional variables using the crisp set qualitative comparative analysis (csQCA) to explore the complex influences between them and the outcome variable through univariate necessity analysis and path configuration analysis.ResultsUnivariate necessity analysis showed that only “Clear Goals” in the structural dimension were necessary for team effectiveness perception. Six pathways to good primary health care team perception of effectiveness were identified. Two of these paths were more typical.Conclusion“Clear Goals” was the core variable that should be emphasized when exploring the mechanism of PHCT formation. The results suggest that human resources in the management team should be rationally allocated, goal-oriented, and given good attention. Future studies should explore complex combinations of PHCT factors to improve the effectiveness of PHCTs.

Analyzing Community Perception of Protected Areas to Effectively Mitigate Environmental Risks Using Qualitative Comparative Analysis: The Case of Savu Sea National Marine Park, East Nusa Tenggara, Indonesia

The Savu Sea holds significant importance as a conservation area in Indonesia that provides sustenance and livelihoods for local communities. However, the sea is currently facing various threats, including overfishing, pollution, and the impacts of climate change. Therefore, the effective management of this conservation area relies heavily on the active participation of local communities. This study aims to address the research question “What combination of variables leads to the positive outcome of strong participation and could thus mitigate environmental risk?” These variables include the socio-economic condition of coastal households, environmental awareness, the existence of community-based conservation areas, attitudes towards activities within the conservation area, and participation in multi-stakeholder institutions. This study employs the crisp-set Qualitative Comparative Analysis (QCA) or csQCA methods. A survey was conducted among 22 coastal villages surrounding the Savu Sea, resulting in the identification of 14 different combinations of pathways that contribute to varying levels of perception regarding conservation. Of these 14 pathways, 10 were found to lead to the positive outcome of strong participation. Valuable lessons can be drawn from this study to enhance the design of policies aimed at effectively managing the Savu conservation area.

The role of International Civil Society Organizations in democratization: A crisp-set QCA approach to anti-corruption in Ghana.

An anti-corruption strategy is essential in the process of continuous democratisation for effective governance. The objective of our study is to examine the mechanisms that contribute to an effective anticorruption strategy in a case study of civil society organisations in Ghana. These CSO cases illustrate the efforts of non-state actors to promote democracy in their interactions with Ghana's government. A model of anticorruption strategy and the crisp-set qualitative comparative analysis (cs-QCA) method were employed to examine 264 cases of local civil societies in Ghana that responded to questions on the conditions for an effective anticorruption strategy. Our results indicate that no single condition is sufficient as an anti-corruption strategy. However, the role of international civil society organisations (RISCO) is necessary for any anticorruption strategy. RISCO has to be combined with freedom of expression, good leadership, fear of punishment, and training to provide an effective strategy. On the other hand, despite the fear of punishment, social trust and leadership, rules and regulations, and training, the absence of RISCO explains all ineffective anticorruption strategies. Therefore, Ghana's anti-corruption strategy must always consider the role of organisations such as Amnesty International (AI), Transparency International (TI), and the Global Organization of Parliamentarians against Corruption (GOPAC) in mitigating corruption. Policymakers should therefore promote the presence of international civil society in Ghana because they ultimately contribute to democratization in addition to all government effort.

Government-university collaboration on smart city and smart government projects: What are the success factors?

Despite the widespread practice of cooperation between governments and universities on smart city and smart government projects, the factors influencing this cooperation are not well known. We explore government-university collaboration to illuminate four potential determinants of success in such projects: output, institutional, relationship, and framework factors. Using mixed methods, including a theoretically informed crisp-set qualitative comparative analysis methodology and thematic analysis of interviews and secondary data, we identify the causal relationships among these determinants and perceived success of government-university collaboration on smart city and smart government projects. We find that for a collaboration to be considered successful, all of these factors must be present and positive. In contrast, a negative assessment of even one of these factors is sufficient to evaluate the collaboration as unsuccessful.

Identifying Resilient and Non-Resilient Labour Conditions in Europe Using Qualitative Comparative Analysis

Abstract Based on the concept of labour market resilience, this paper is aimed to determine the combination of initial conditions behind resilient and non-resilient labour markets after the financial crisis in 2008 in Europe. We start from the assumption that some initial conditions in 2007 are crucial to achieve a specific labour result when a shock appears. In this sense, the effect of temporary employment in cyclical sectors, labour market flexibility, the level of education among the workforce, and the expenditure on Labour Market Policies (LMP) have been tested using crisp-set Qualitative Comparative Analysis (csQCA) in 25 European countries. Whilst our results do not explain labour market resilience in its entirety, we have found a model explaining 85% of the non-resilient cases. These findings suggest that the different levels of initial conditions may have prompted dissimilar labour adjustments with varying success rates in dealing with the job losses.

Analysis of factors influencing the organizational capacity of Institutional Review Boards In China: a crisp-set Qualitative Comparative Analysis based on 107 cases

BackgroundInstitutional Review Boards (IRBs) play a vital role in safeguarding the rights and interests of both research participants and researchers. However, China initiated the establishment of its own IRB system relatively late in comparison to international standards. Despite commendable progress, there is a pressing need to strengthen the organizational capacity building of Chinese IRBs. Hence, this study aims to analyze the key factors driving the enhancement of organizational capacity within these committees.MethodThe cross-sectional survey for this research was conducted from July 2020 to January 2022. Following the statistical grouping based on the "2020 China Health Statistical Yearbook", a systematic investigation of IRBs in various provinces of China was carried out. In-depth interviews and questionnaire surveys were conducted with the chairpersons and administrative executives (or secretaries) of highly cooperative IRBs. Subsequently, data were collected from 107 IRBs. Qualitative Comparative Analysis (QCA) was employed as the method to analyze the factors influencing the organizational capacity of medical ethics committees and explore the diverse combinations of these factors.ResultsThrough a singular necessary condition analysis, the variable "protection of rights and interests" emerges as a critical factor contributing to the robust construction of Institutional Review Boards Institutional Review Boards (IRBs). Conversely, the variables of "lack of member ability, absence of review process, and deficiency in the supervision mechanism" collectively constitute a sufficient condition leading to weaker IRB construction. The state analysis uncovers three interpretation modes: member ability-oriented (M1), system process-oriented mode (M2), and resource system-oriented mode (M3).ConclusionsThe results of this study are effectively explicable using the "Triangular Force" model proposed for the hypothesis of IRBs' organizational capacity, which provides a solid foundation for the development of organizational capabilities in IRBs. To enhance the organizational capacity of IRBs in China, it is imperative to elevate the competence of committee members and strengthen team development. This can be achieved by establishing a comprehensive regulatory framework and refining procedural protocols. Moreover, clarifying the organizational structure and optimizing resource allocation are essential steps in bolstering the overall organizational capabilities of these committees.

A Social Network Approach to the Dual Aspect of Moral Competence

This work presents evidence supporting the relationship between the dual aspect of moral competence (emotion and cognition) and social networks in school settings. We conducted empirical research with 160 students from various disciplines of the social sciences and different cohorts in two Brazilian public universities. Firstly, the participants responded to Georg Lind’s Moral Competence Test (MCT-xt). Following this, a sociometric generator regarding relationships of friendship and collaboration in social networks was applied, and several Exponential Random Graphs Models (ERGMs), with the MCT-xt score as an exogenous effect and predictor of these relationships, were utilized. We also used a Crisp-Set Qualitative Comparative Analysis in order to determine if the cohorts, where the average MCT-xt was associated with the interactional structure, obeyed the same causal configuration. There exist two conditional configurations: (1) a sufficient score of MCT-xt in a social network with homogeneous status encourages a proactive search of collaboration; (2) an insufficient score of MCT-xt in a social network with homogeneous status encourages a collaborative exchange based on the popularity of some individuals. This work reveals how to interpret, at the grouping level, the results of MCT-xt.

Identifying Combinations of Altmetrics and Web of Science Usage That Linked to Early Citations of an Article Received: A Crisp-Set Qualitative Comparative Analysis (csQCA)

The relations of altmetrics/usage of an article and its citations have been studied extensively by using several variable-oriented approaches, e.g., correlations analysis, regression analysis, and so on. Variable-oriented approaches are symmetrically designed to estimate the “net effects” of independent variables on outcomes. In contrast to variable-oriented approaches, Qualitative Comparative Analysis (QCA), a case-oriented approach based on set theory, models the concept of conjunctural causation, rather than a single net effect. QCA assumes asymmetry, equifinality, and causal complexity. In this study, based on four data sets from Scientific Reports, a Crisp-set Qualitative Comparative Analysis (csQCA) was employed to identify combinations of altmetrics and Web of Science usage (WOSusage) that linked to early citations an article received. Our results revealed the existence of diverse combinations of altmetrics and WOSusage that linked to early citations. The four combinations with the highest raw coverage for each data set indicated that high Mendeley readers together with high WOSusage played a key role in early citations an article received. The other altmetrics, including Twitter, Facebook, blogs, and news, played roles in linking to early citations an article received but varied in different combinations for each data set.

Modeling systems of sentencing in early inquisition trials: Crime, social connectivity, and punishment in the register of Peter Seila (1241–2)

Despite significant research on the techniques of repression employed by medieval inquisitors against religious dissidents, the case-level influences on the penances they meted out are understood only vaguely: the extent to which sentencing “systems” existed is unknown. To overcome this, we apply formal methods – an exploratory analysis supported by crisp-set Qualitative Comparative Analysis, and statistical modeling founded on multiple linear regression – to the large and historically significant register of Peter Seila (1241–2), captured as structured data via a statement-based approach entitled “Computer-Assisted Semantic Text Modelling” (CASTEMO). The results show that Peter systematically weighted different types of crimes and dissident interactions when sentencing; they do not suggest, however, that he was influenced by accomplicity or kinship among the sentenced.

The non-use of evidence in the adoption of a sugar-sweetened beverage tax in OECD countries.

Studies confirm the positive effect of sugar-sweetened beverage (SSB) taxation on public health. However, only a few countries in Europe adopt SSB taxes. From a public policy perspective, we investigate the conditions under which countries do or do not follow this evidence. Crisp-set Qualitative Comparative Analysis (QCA) of 26 European Organization of Economic Cooperation and Development countries with and without an SSB tax. We test which configurations of conditions (problem pressure, governmental composition, strategic planning, health care system, public health policies, inclusion of expert advice in policymaking) emerge as relevant in determining adoption and non-adoption between the years 1981 and 2021. Pathways that lead to the presence and absence of SSB taxes are identified separately. At least one of the following configurations of conditions is present in countries that introduced taxation: (i) high financial problem pressure, low regulatory impact assessment activity; (ii) high public health problem pressure, a contribution-financed health care system, no holistic strategy for combatting non-communicable diseases (NCDs); (iii) a tax-financed health care system, a holistic NCD strategy, high strategic and executive planning capacity. In countries that did not adopt SSB taxes, we find (i) high regulatory impact assessment activity, high levels of sugar export; (ii) no holistic NCD strategy, high spending on preventive care; (iii and iv) a lack of strategic planning capacity and either a high share of spending on preventive care or inclusion of expert advice. Evidence inclusion requires clear policy priorities in terms of strategy and resources to promote public health.

Social Policy Expansion and Retrenchment in Latin America: Causal Paths to Successful Reform

Abstract The literature on social policy expansion and retrenchment in Latin America is vast, but scholars differ in how they explain outcomes, arriving at different conclusions about the role of democracy, left parties, favorable economic conditions, and social movements. What can welfare state developments since the end of the commodity boom teach us about the theoretical power of these arguments? This paper engages this question, seeking to explain recent incidents of successful social policy reform in 10 presidential administrations in Argentina, Brazil, Chile, and Uruguay. Using a combination of crisp-set qualitative comparative analysis (csQCA) and case studies, we identify multiple paths toward successful social policy expansion and retrenchment. The QCA results highlight two key findings. First, social policy expansion was generally carried out by programmatic parties (often, though not always, from the left). Second, retrenchment is most likely when nonprogrammatic right parties face fiscal constraints. The case studies affirm these findings and show that differences in electoral competition, social movement pressure, and policy legacies shape the contexts in which expansion and retrenchment is feasible. The results provide new insight into social policy reform, underscoring the relevance of complex forms of causality.

Business models for digital sustainability: Framework, microfoundations of value capture, and empirical evidence from 130 smart city services

The emerging research stream on digital sustainability examines how digital technologies enable the creation of environmental and social value. The need to finance the creation of such value calls for a business model perspective that combines value creation and value capture. To extend the digital sustainability literature in this regard, we adopt a microfoundations perspective and argue that the configuration of value creation influences the decision of users to pay for a value proposition or not, which in turn affects organizational value capture. Applying a crisp-set qualitative comparative analysis to 130 smart city initiatives in Switzerland, we develop a three-dimensional framework of business models for digital sustainability. The framework comprises 12 theoretically possible business model types, representing distinct business model configurations. We contribute to the digital sustainability and the microfoundations literatures by analyzing, explaining, and classifying the diversity of digitally enabled business models in the context of smart cities.

A Qualitative Comparative Analysis to explore the predictors of individuals’ willingness towards vaccination

The emergence of COVID-19 traumatized individuals from all walks of life and while the demand for vaccines increased exponentially, the authorities seem to encounter greater challenges on their road to create herd immunity. Governments initiated numerous campaigns to influence individuals to opt for vaccination and India being a diverse country makes it difficult to understand the motivating factors for getting COVID-19 vaccination.The study aimed to explore the predictors of individuals’ willingness to get vaccinated using Qualitative Comparative Analysis (QCA). After screening using the vaccine hesitancy scale, a semi-structured interview was conducted among 30 respondents from India. Crisp Set QCA was utilized to analyse the data which lead to nine conditions.A solution combination of seven conditions showed a consistency of 1 and coverage of 0.6. They included knowledge about vaccines, perceived severity of the COVID-19 virus, family and peer influence, media and health department's influence, a sense of social responsibility, trust in the authorities and vaccine efficacy.This study contributes to the relevance of QCA's use in psychological research, especially to identify predictors of willingness to immunize. The findings of this study would help in designing appropriate interventions to enhance willingness to get vaccinated.

How to become an excellent pediatric resident: a qualitative comparative study from China

BackgroundCompetency-oriented medical education has become a global trend. However, most current studies focus on the independent effects of various competencies and lack an examination of the combined effects. Therefore, the purpose of this study was to explore the competency configurations of excellent pediatric residents and general pediatric residents and to provide a scientific reference for the talent training and career development of pediatric residents.MethodsBehavioral event interviews were conducted with 23 pediatric residents at a children's hospital in Beijing in July and August 2019. Two researchers coded the interview data to summarize the competency of pediatric residents. The research group scored the performance of 23 pediatric residents in various aspects of competency and used the crisp-set qualitative comparative analysis method to explore the competency configurations of excellent pediatric residents and general pediatric residents.ResultsThis study concludes that pediatric residents should have six core competencies: professional spirit, clinical skills, communication ability, learning ability, mental capacity and research ability. There are 4 combinations of competencies for becoming an excellent pediatric resident: the clinical type, scientific research type, all-around development type and high emotional intelligence type. In addition, there are 3 combinations of competencies for becoming a general pediatric resident: the comprehensive ability deficiency type, lack of professionalism and mental capacity type, lack of communication ability type.ConclusionsThere are differences in competence between excellent and general pediatric residents. Excellent pediatric residents do not need to possess all competencies but should specialize in clinical practice, scientific research or communication skills. This study suggests that training in mental capacity, professional spirit and communication ability should be strengthened during pediatric resident training. Pediatric residents should make career development plans according to their actual situation, and hospitals should arrange suitable positions according to the characteristics of pediatric residents.

Does Help-Seeking Message Content Impact Online Charitable Behavior? A Qualitative Comparative Analysis Based on 40 Waterdrop Projects

A help-seeking message is composed of abundant types of content; therefore, it is unsuitable for analysis by the traditional methods that assume that variables are independent of one another. To address this problem, we introduced qualitative comparative analysis (QCA) to explore the synergistic effects of help-seeking message content on online charitable behavior. Crisp-set QCA and fuzzy-set QCA were both used to analyze qualitative and quantitative data from 40 Waterdrop projects. To analyze the qualitative data, three members of our research team intensively and separately read a large number of help-seeking messages, analyzed and summarized the main content referring to previous studies on charitable donation, extracted rational appeals, positive emotions, negative emotions, moral appeals, and the economic condition as condition variables, and finally determined the coding rules collaboratively. The necessity analysis results show that moral appeals and rational appeals are necessary conditions for online charitable behavior. The sufficiency analysis results show that there are three configurations impacting online charitable behavior. This study can help inspire future studies shifting from a traditional perspective to a configuration perspective and help seekers obtain more charitable donations.

Pathways to TASER discharge: Qualitative comparative analysis of police use of force

Abstract We used a crisp-set Qualitative Comparative Analysis (csQCA) to analyse of how key conditions interact within police use of force incidents to contribute to Conducted Energy Devices (CED), commonly known by the brand name TASER, being drawn and red-dotted (0), or drawn, red-dotted, and fired (1). Our sample is 22 incidents (11 red-dotted, 11 red-dotted and fired) between one officer and one person subjected to force recorded in the Use of Force Monitoring Forms for CED incidents from one of the 43 police forces in England and Wales. We identify the most parsimonious causal recipes for both outcomes using five causal conditions –i.e. Intoxication, Intelligence, Prior Knowledge, Weapon Possession, and Aggression. We found three different pathways to CED being red-dotted (0) and five distinct pathways to CED being red-dotted and fired (1). Our findings show that reported intelligence and prior knowledge play central roles in shaping causal recipes, and reported aggression by the member of the public is critical to CED firing decisions.

Implementation of e-Mental Health Interventions for Informal Caregivers of Adults With Chronic Diseases: Mixed Methods Systematic Review With a Qualitative Comparative Analysis and Thematic Synthesis.

Informal caregivers commonly experience mental health difficulties related to their caregiving role. e-Mental health interventions provide mental health support in a format that may be more accessible to informal caregivers. However, e-mental health interventions are seldom implemented in real-world practice. This mixed methods systematic review aimed to examine factors associated with the effectiveness and implementation of e-mental health interventions for informal caregivers of adults with chronic diseases. To achieve this aim, two approaches were adopted: combinations of implementation and intervention characteristics sufficient for intervention effectiveness were explored using qualitative comparative analysis, and barriers to and facilitators of implementation of e-mental health interventions for informal caregivers were explored using thematic synthesis. We identified relevant studies published from January 1, 2007, to July 6, 2022, by systematically searching 6 electronic databases and various secondary search strategies. Included studies reported on the effectiveness or implementation of e-mental health interventions for informal caregivers of adults with cancer, chronic obstructive pulmonary disease, dementia, diabetes, heart disease, or stroke. Randomized controlled trials reporting on caregivers' mental health outcomes were included in a crisp-set qualitative comparative analysis. We assessed randomized controlled trials for bias using the Risk of Bias 2.0 tool, and we assessed how pragmatic or explanatory their trial design was using the Pragmatic Explanatory Continuum Indicator Summary 2 tool. Studies of any design reporting on implementation were included in a thematic synthesis using the Consolidated Framework for Implementation Research to identify barriers to and facilitators of implementation. Overall, 53 reports, representing 29 interventions, were included in the review. Most interventions (27/29, 93%) focused on informal cancer or dementia caregivers. In total, 14 reports were included in the qualitative comparative analysis, exploring conditions including the presence of peer or professional support and key persuasive design features. Low consistency and coverage prevented the determination of condition sets sufficient for intervention effectiveness. Overall, 44 reports were included in the thematic synthesis, and 152 barriers and facilitators were identified, with the majority related to the intervention and individual characteristic domains of the Consolidated Framework for Implementation Research. Implementation barriers and facilitators in the inner setting (eg, organizational culture) and outer setting (eg, external policies and resources) domains were largely unexplored. e-Mental health interventions for informal caregivers tend to be well-designed, with several barriers to and facilitators of implementation identified related to the intervention and individual user characteristics. Future work should focus on exploring the views of stakeholders involved in implementation to determine barriers to and facilitators of implementing e-mental health interventions for informal caregivers, focusing on inner and outer setting barriers and facilitators. PROSPERO (International Prospective Register of Systematic Reviews) CRD42020155727; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020155727. RR2-10.1136/bmjopen-2019-035406.

How do moral hazard behaviors lead to the waste of medical insurance funds? An empirical study from China.

The huge loss of health insurance funds has been a topic of concern around the world. This study aims to explore the network of moral hazard activities and the attribution mechanisms that lead to the loss of medical insurance funds. Data were derived from 314 typical cases of medical insurance moral hazards reported on Chinese government official websites. Social network analysis (SNA) was utilized to visualize the network structure of the moral hazard activities, and crisp-set qualitative comparative analysis (cs/QCA) was conducted to identify conditional configurations leading to funding loss in cases. In the moral hazard activity network of medical insurance funds, more than 50% of immoral behaviors mainly occur in medical service institutions. Designated private hospitals (degree centrality = 33, closeness centrality = 0.851) and primary medical institutions (degree centrality = 30, closeness centrality = 0.857) are the main offenders that lead to the core problem of medical insurance fraud (degree centrality = 50, eigenvector centrality = 1). Designated public hospitals (degree centrality = 27, closeness centrality = 0.865) are main contributor to another important problem that illegal medical charges (degree centrality = 26, closeness centrality = 0.593). Non-medical insurance items swap medical insurance items (degree centrality = 28), forged medical records (degree centrality = 25), false hospitalization (degree centrality = 24), and overtreatment (degree centrality = 23) are important immoral nodes. According to the results of cs/QCA, low-economic pressure, low informatization, insufficient policy intervention, and organization such as public medical institutions, were the high-risk conditional configuration of opportunism; and high-economic pressure, insufficient policy intervention, and organizations, such as public medical institutions and high violation rates, were the high-risk conditional configuration of risky adventurism (solution coverage = 31.03%, solution consistency = 90%). There are various types of moral hazard activities in medical insurance, which constitute a complex network of behaviors. Most moral hazard activities happen in medical institutions. Opportunism lack of regulatory technology and risky adventurism with economic pressure are two types causing high loss of funds, and the cases of high loss mainly occur before the government implemented intervention. The government should strengthen the regulatory intervention and improve the level of informatization for monitoring the moral hazard of medical insurance funds, especially in areas with low economic development and high incident rates, and focus on monitoring the behaviors of major medical services providers.