民办高校学生卫生服务利用和医疗保障现状及其影响因素研究

发布时间：2018-06-12 12:25

本文选题：民办高校学生 + 卫生服务需求　；参考：《南华大学》2013年硕士论文

【摘要】：目的探索湖南省民办高校学生卫生服务需求、利用和医疗保障的现状，及其影响因素，找出民办高校学生医疗保障存在的问题，为制定促进民办高校学生健康的医疗保障制度与措施提供依据。方法采用整群随机抽样方法，在湖南省随机抽取四所民办高校，包括两所本科院校和两所专科学校，然后再在每所学校各个年级随机抽取3个班级共45个班级2438名学生，利用民办高校学生卫生服务利用和医疗保障调查表，以班为单位调查民办高校学生的卫生服务需求、利用和医疗保障现状及其影响因素。结果 1、民办高校学生的卫生服务需求及其影响因素民办高校学生两周患病率为15.92%，半年慢病患病率为2.73%；各民办高校之间、本科与专科学生间、不同家庭经济状况的学生的两周患病率差异无统计学意义（P0.05）；一年级学生两周患病率高于其余年级（P0.05），女生两周患病率高于男生（P=0.006）；城镇来源的学生两周患病率高于农村（P=0.008），体育锻炼对学生两周患病率有影响（P=0.008），经常体育锻炼的学生两周患病率最低，从不锻炼的学生两周患病率最高，，不良生活习惯的学生两周患病率高于生活习惯良好的学生（P=0.000）；仅14.55%的学生经常参加体育锻炼，有35.05%的学生从不参加体育锻炼，有不良生活习惯的学生的比例占65.92%；年级、学历层次、城镇与农村来源、家庭经济状况对学生半年慢病患病率均无影响（P0.05）。 2、民办高校学生医疗卫生服务利用及其影响因素民办高校学生两周患病就诊率为39.9%，学生一年住院率为4.23%，需要住院而未住院率为2.29%；医学院校学生两周患病就诊率低于非医学院校（P=0.008），专科学生的就诊率高于本科院校（P=0.002）；女生就诊率高于男生（P=0.043）；来源于城镇学生就诊率高于农村的（P=0.030）；家庭收入对学生两周患病就诊率有影响（P=0.024），人均收入越低，学生就诊率越低。本、专科学生两周患病首诊医疗机构的选择不同（P=0.000），本科学生两周患病首诊在校医务室和社区卫生服务中心的比例69.1%，两所专科学校没有医务室，学生两周患病首诊主要选择私人诊所和社区卫生服务中心。学生两周患病的自我医疗率为33.1%，医科类学生自我医疗率高于其他类的学生（P=0.036），来源于农村的学生自我医疗率高于来源于城镇的学生（P=0.004）；年级、性别、家庭收入、生活习惯、体院锻炼等与学生两周患病自我医疗率无关（P0.05）；29.6%的两周患病学生未进行任何治疗，未诊的最主要原因是经济困难，其次是自感病轻不需要治疗，医院服务差、技术差也是学生不就诊的一个重要原因，学生对学校医疗服务的满意度很差。 3、民办高校学生医疗保障现状民办高校学生的城镇居民医保和意外伤害保险的参保率分别为96.7%和94.4%，但学生对自己参保的知晓率较低，分别为59.7%和58.8%；各校学生的参保率无差异（P0.05），本科学生对医保和意外伤害险的知晓率稍高于专科学生（P0.05）；学生对学校的医疗保障制度、措施的知晓率仅为42.3%，认为学校无任何医疗保障制度、措施，即使有也没有起任何作用。民办高校学生不愿参加城镇居民医保和意外伤害保险比例高达30%以上，民办高校学生参加城镇居民医保和意外伤害保险具有一定的强制性。学生不愿参保的原因主要是对医保政策不了解，其次是投保费高、报销比例低、作用不大，理赔麻烦也是学生不愿参保的原因之一。民办高校8.7%参保学生医疗费用得到了部分报销，报销过住院费的学生占参保人数的4.3%，报销过门诊费的占4.6%，两者都报销过占1.7%。结论 1、湖南省民办高校学生患病后就诊率和住院率偏低，民办学校应加强学生医疗保健意识教育，引导正确的就医行为。 2、湖南省民办高校的基本医疗服务、预防保健、健康教育匮乏，医疗设施缺少，学校应增加医疗卫生服务投入，建立校医务室及改善校医务室的条件，并将校医务室建成为社区卫生服务中心（站）。 3、湖南省民办高校学生已纳入国家基本医疗保障范畴，建立了多种医疗保障体系。但民办高校学生的参保意识不强，学生对医疗保障制度与措施的知晓率低，学生参保基本上是学校强制性，参保利用率低，学校应采用多种方式，提高大学生的自愿参保率。
[Abstract]:Purpose

To explore the present situation of health service demand , utilization and medical security in private colleges and universities in Hunan Province , and to find out the problems existing in the medical security of the students in the private colleges and universities , and to provide the basis for the establishment of the health care system and measures to promote the health of the students in the private colleges .

method

In this paper , four private colleges , including two universities and two special schools , were randomly selected in Hunan Province , including two universities and two special schools , and then three classes of 2438 students were randomly selected in each grade of each school , and the health service demand , utilization and medical security status of the students in private colleges and universities were investigated .

Results

1 . The two - week prevalence rate of students ' health service in private colleges and universities was 15.92 % and 2.73 % in half a year .
There was no significant difference in the two - week prevalence among the students between the private colleges and universities , between the undergraduate and the special students ( P0.05 ) .
The two - week prevalence rate of the first - grade students was higher than that of the rest ( P0.05 ) , and the two - week prevalence rate of girls was higher than that of boys ( P = 0.006 ) ;
The two - week prevalence rate of students in urban areas was higher than that in rural areas ( P = 0.008 ) . Physical exercise had an impact on the two - week prevalence of students ( P = 0.008 ) . The two - week prevalence rate of students who had never been exercising was the highest , and the two - week prevalence rate of students with poor living habits was higher than that of students with good living habits ( P = 0.000 ) ;
Only 14.55 % of the students often take part in physical exercise , 35.05 % of the students never take part in physical exercise , and the proportion of students with poor living habits accounts for 65.92 % ;
Grade , educational level , town and rural source , family economic situation had no effect on the prevalence of half - year ' s slow disease ( P0.05 ) .

2 . The medical and health service utilization of the students in private colleges and universities and the influencing factors were 39.9 % and 4.23 % in one year , and the hospitalization rate was 2.29 % .
The rate of visits of students in medical college was lower than that of non - medical college ( P = 0.008 ) , and the rate of attendance was higher than that in colleges and universities ( P = 0.002 ) .
The attendance rate of girls was higher than that of boys ( P = 0.043 ) .
The rate of visits from town students was higher than in rural areas ( P = 0.030 ) .
Family income has an impact on the rate of two - week illness of students ( P = 0 . 024 ) , the lower per capita income , the lower the rate of student visits . The rate of two - week sick first - diagnosis medical institution in the specialty students is different ( P = 0.000 ) . Two - week ill - diagnosis of undergraduate students is different from that of the community health service center ( P = 0.000 ) . Two colleges have no medical room , and two weeks of ill - diagnosis of students mainly choose private clinics and community health service centers .

The self - medical rate of students in the two weeks was 39.1 % , and the self - medical rate of medical students was higher than that of other students ( P = 0.036 ) . The self - medical rate of students from rural areas was higher than those from the town ( P = 0.004 ) .
Grade , sex , family income , living habits , physical training and so on were not related to the students ' self - medical rate in two weeks ( P0.05 ) ;
29 . 6 % of the two sick students did not receive any treatment , the most important cause of missed diagnosis was economic difficulties , followed by the lack of treatment due to self - feeling , poor hospital service , poor technical difference , and one of the important reasons for the students not to visit , and the student ' s satisfaction with the school medical service was very poor .

3 . The insured rate of medical insurance and accidental injury insurance for students in private colleges and universities is 96.7 % and 94.4 % respectively , but the awareness rate of students to their own insured is 59.7 % and 58.8 % , respectively .
There was no difference in the students ' participation rate ( P0.05 ) . The knowledge rate of undergraduate students to health insurance and accidental injury insurance was slightly higher than that of college students ( P0.05 ) .
The student ' s awareness rate of the school ' s health care system is only 42.3 % , and it is believed that the school has no health care system and measures , even if it has not played any role .

Private colleges and universities are reluctant to take part in the medical insurance and accidental injury insurance of urban residents up to more than 30 % , and the students of private colleges and universities are compulsory to participate in the insurance of urban residents ' medical insurance and accidental injury . The reasons for the reluctance of students to participate in insurance are not to know the health insurance policy , secondly , the insurance premium is high , the reimbursement proportion is low , the effect is not large , the problem of claim settlement is also one of the reasons why students are unwilling to participate in the insurance .

The medical expenses of 8.7 % of the students in the private colleges and universities were partly reimbursed , and the students who had been reimbursed for hospitalization accounted for 4.3 % of the insured persons and 4.6 % of the reimbursement rates , both of which were reimbursed for 1.7 % .

Conclusion

1 . The rate and the hospitalization rate of the students in the private colleges and universities in Hunan Province are low , and the private schools should strengthen the education of the students ' health care awareness and guide the correct medical behavior .

2 . The basic medical service , prevention and health care , lack of health education and lack of medical facilities in the private colleges and universities in Hunan Province , the school should increase the input of medical and health services , establish the medical service room and improve the conditions of the school clinic , and set up the school medical room as the community health service center ( station ) .

3 . The students of private colleges and universities in Hunan have been integrated into the national basic medical security category , and various medical security systems have been established . However , the awareness of the students in the private colleges and universities is not strong , the students ' awareness of the medical security system and the measures is low , the students ' participation in the insurance is basically compulsory and the utilization rate of the students is low , and the school should adopt various ways to improve the voluntary participation rate of college students .
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R197;G647.8

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