鄂州市城乡居民医疗保险满意度及其影响因素研究

发布时间：2018-01-17 20:22

本文关键词：鄂州市城乡居民医疗保险满意度及其影响因素研究　出处：《武汉大学》2017年硕士论文　论文类型：学位论文

【摘要】：长期以来,我国大部分地区由于受城乡二元社会结构的影响,城乡医疗保险制度呈现出比较明显的二元结构,同时制度也表现出比较严重的碎片化现象,从而造成城乡之间医疗卫生资源配置的不均衡。随着城镇化的推进,统筹城乡一体化,缩小城乡差别,推动城乡医疗保险制度的一体化发展成为重要议题。2016年1月份国务院发布了《关于整合城乡居民基本医疗保险制度的意见通知》,提出要按照保基本、全覆盖、多层次、可持续的方针,推进城镇居民医疗保险制度和新型农村合作医疗制度的整合,在全国范围内逐步建立起一体化的城乡居民医疗保险制度。截止到2016年底,全国有2/3的省份对建立统一的城乡居民医疗保险制度进行了总体规划部署或者已经全面实现了整合。城乡医疗保险一体化,有利于缩小城市和乡村的基本医疗待遇差异,实现医疗资源配置的公平,顺应了我国统筹城乡一体化的发展趋势。鄂州市是湖北省城乡居民医疗保险一体化改革的试点城市,从2008年就实现了城乡居民医疗保险制度的整合,如今已经走过了近10年。在这期间,鄂州市人力资源和社会保障局在城乡居民医保制度方面做出了不懈努力,不断创新和完善医疗保险管理体制,积累了丰富的经验。本文的研究目的是通过对鄂州市参加城乡居民医保的居民进行问卷调查和走访交谈,从参保居民的角度出发,以居民医保制度的目标为条件,以保障居民的健康水平为目的,通过统计分析参保居民对居民医保的满意度,构建参保居民对居民医保的满意度影响因素模型,分析影响因素,对鄂州市城乡居民医保的进一步完善提出政策建议,同时为国内已经整合城镇居民医保和新农合的地区提供借鉴和参考。本文应用了武汉大学社会保障研究中心关于"城乡居民医疗保险满意度调查"的数据,从中选取了鄂州市凤凰街道和古楼街道两个城区以及太和镇和沼山镇两个乡镇共240份问卷进行了分析。分析结果显示,鄂州市参保居民对居民医保制度总体上比较满意,其中能够显著影响居民对医保满意度的因素主要有5个,分别是定点医疗机构的医疗条件和技术水平、医疗工作人员的服务态度、医疗保险的报销比例、医疗保险制度可报销的病种和药品范围以及经办管理机构的工作能力和服务态度。基于上文的研究,本文提出如下政策建议:第一要提高医疗条件和技术水平,提升医务人员素质。第二要合理确定报销比例,与时俱进调整报销范围。第三是要加强医疗保险经办管理机构的工作能力建设。
[Abstract]:For a long time, due to the influence of urban-rural dual social structure, the urban-rural medical insurance system has shown a more obvious dual structure, at the same time, the system also shows a relatively serious fragmentation phenomenon. As a result, the allocation of medical and health resources between urban and rural areas is not balanced. With the development of urbanization, the integration of urban and rural areas, reducing the urban-rural differences. Promoting the integration of urban and rural medical insurance system has become an important issue. In January 2016, the State Council issued the notice of opinions on the Integration of the basic Medical Insurance system of Urban and Rural residents. Full coverage, multi-level, sustainable policy to promote the integration of urban residents medical insurance system and the new rural cooperative medical system. An integrated medical insurance system for urban and rural residents has been gradually established throughout the country until end of 2016. There are 2/3 provinces in the country to establish a unified medical insurance system for urban and rural residents of the overall planning or has been fully integrated. Urban and rural medical insurance integration. It is helpful to reduce the difference of basic medical treatment between urban and rural areas and to realize the fair allocation of medical resources. Ezhou is a pilot city of urban and rural residents' medical insurance integration reform in Hubei Province. Since 2008, it has realized the integration of urban and rural residents' medical insurance system. During this period, Ezhou Bureau of Human Resources and Social Security has made unremitting efforts in the medical insurance system of urban and rural residents, and has constantly innovated and improved the medical insurance management system. The purpose of this study is to conduct questionnaires and interviews to the residents of Ezhou who participate in the medical insurance of urban and rural residents, from the point of view of insured residents. Based on the objective of the residents' medical insurance system and the aim of ensuring the residents' health level, this paper analyzes the satisfaction degree of the insured residents to the residents' medical insurance, and constructs a model of the influencing factors of the residents' satisfaction with the residents' health insurance. This paper analyzes the influencing factors, and puts forward some policy recommendations for the further improvement of medical insurance for urban and rural residents in Ezhou. At the same time for the integration of urban residents health insurance and new rural areas to provide reference and reference. This paper applies the Wuhan University Social Security Research Center on the "urban and rural residents' medical insurance satisfaction survey" data. Two districts of Fenghuang Street and Gulou Street of Ezhou City and two towns of Taihe Town and Biaoshan Town were selected for analysis. The residents of Ezhou are satisfied with the medical insurance system, among which there are five main factors which can significantly affect the satisfaction of the residents, namely, the medical conditions and the technical level of the designated medical institutions. The service attitude of medical staff, the proportion of reimbursement of medical insurance, the range of diseases and medicines reimbursable by the medical insurance system, and the working ability and service attitude of administrative agencies. Based on the study above. This paper puts forward the following policy recommendations: first, to improve the medical conditions and technical level, to improve the quality of medical personnel; second, to determine the proportion of reimbursement. The third is to strengthen the work capacity of medical insurance agencies.
【学位授予单位】：武汉大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：F842.684

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