张家港市统筹城乡居民基本医疗保险制度运行研究

发布时间：2018-02-13 05:39

本文关键词： 医疗保险城乡居民基本医疗保险运行研究张家港市　出处：《西北农林科技大学》2016年硕士论文　论文类型：学位论文

【摘要】：医疗保障是社会保障的重要内容,而当下城乡二元分割的医保体系已越来越不适应经济的发展,阻碍了我国城乡一体化的进程,损害了我国医保制度一直以来所追求的公平性。张家港市凭借强大的经济实力及对医保体系的不断探索,2008年直接将新型农村合作医疗保险制度更名为城乡居民基本医疗保险制度。2012年,张家港市又大力促成了居民医保以及城镇职工医保的全面整合,实现了在人员配置、管理制度、经办机构、药品目录等方面全方位统一。这一举措,从小的方面来说是完善了张家港市城乡一体化的基本医疗保障体系,从大的方面来说是促进了我国公共卫生服务均等化的进程。目前,国内外学者对城乡医保统筹的目标趋于一致,但关注点多集中在城乡医保统筹的必要性、可行性、路径探索、制度统筹中可能面临的困难及障碍、完善建议方案等方面。但就总体而言,定性研究的多,定量研究的少;讨论的部分多,实践的部分少。本文针对张家港市城乡医保统筹进行实证研究,以张家港市城乡居民基本医疗保险制度的运行情况为研究对象,通过文献、政策整理、问卷调查、深度访谈、数据分析等方式,重点通过对张家港市统筹城乡居民基本医疗保险制度的运行效果分析,进一步选取张家港市锦丰镇5个村(社区)的500名参保居民为研究对象进行调查问卷,从而获得参保居民对张家港市统筹城乡居民基本医疗保险制度的认知度、满意度、参保意愿,总体评价等指标的第一手数据资料,进而探究现行制度在执行过程中出现的参保居民对筹资机制、医疗机构服务水平、医保待遇保障水平满意度不高,对制度的了解程度不高等问题,并据此有针对性的提出明确城乡居民参保的强制性、分层次确定筹资标准、加大财政投入力度、拓宽筹资渠道、适度提高保障水平、加大政府宣传“深度”、加强对医疗机构的建设与管理等方面的对策和建议,以期对统筹城乡居民基本医疗保险制度的完善有所助力。
[Abstract]:Medical security is an important part of social security, but the current medical insurance system, which is divided between urban and rural areas, is becoming more and more unsuitable for the development of economy, which hinders the process of urban-rural integration in our country. Zhangjiagang, with its strong economic strength and constant exploration of the medical insurance system, directly renamed the new rural cooperative medical insurance system as the base of urban and rural residents in 2008. This medical insurance system. 2012, Zhangjiagang City has also made great efforts to promote the comprehensive integration of medical insurance for residents and urban workers, and has realized a comprehensive unification in terms of staffing, management systems, agencies, drug catalogs, and so on. This move, From a small point of view, it has improved the basic medical security system of urban and rural integration in Zhangjiagang, and in a large way has promoted the process of equalization of public health services in China. At present, Scholars at home and abroad tend to be consistent on the goal of urban and rural health insurance coordination, but the focus is on the necessity, feasibility, path exploration, difficulties and obstacles in the planning of urban and rural health insurance. But on the whole, there are more qualitative research, less quantitative research, more discussion and less practice. This paper makes an empirical study on the urban and rural health insurance coordination in Zhangjiagang. Taking the operation of the basic medical insurance system of urban and rural residents in Zhangjiagang as the research object, through literature, policy collation, questionnaire survey, in-depth interview, data analysis and so on, By analyzing the effect of the basic medical insurance system in Zhangjiagang as a whole, 500 residents of five villages (communities) in Jinfeng Town, Zhangjiagang City, are selected as the research objects. Thus obtaining the first-hand data of the insured residents on the basic medical insurance system of urban and rural residents as a whole in Zhangjiagang City, the degree of satisfaction, the willingness to participate in the insurance, the overall evaluation, and so on. And then explore the current system in the process of implementation of the insured residents of the financing mechanism, the level of service of medical institutions, medical insurance treatment level of satisfaction is not high, the understanding of the system is not high, and so on. Based on the above, it is pointed out that it is mandatory for urban and rural residents to participate in insurance, to determine the standard of raising funds in different levels, to increase financial input, to widen the channels of financing, and to raise the level of security moderately. Strengthen the government propaganda "depth", strengthen the construction and management of medical institutions and other aspects of countermeasures and suggestions, in the hope of urban and rural residents as a whole to improve the basic medical insurance system.
【学位授予单位】：西北农林科技大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F842.684;R197.1

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