本文關(guān)鍵詞：鄂州市城鄉(xiāng)居民醫(yī)療保險(xiǎn)滿意度及其影響因素研究　出處：《武漢大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：長(zhǎng)期以來(lái),我國(guó)大部分地區(qū)由于受城鄉(xiāng)二元社會(huì)結(jié)構(gòu)的影響,城鄉(xiāng)醫(yī)療保險(xiǎn)制度呈現(xiàn)出比較明顯的二元結(jié)構(gòu),同時(shí)制度也表現(xiàn)出比較嚴(yán)重的碎片化現(xiàn)象,從而造成城鄉(xiāng)之間醫(yī)療衛(wèi)生資源配置的不均衡。隨著城鎮(zhèn)化的推進(jìn),統(tǒng)籌城鄉(xiāng)一體化,縮小城鄉(xiāng)差別,推動(dòng)城鄉(xiāng)醫(yī)療保險(xiǎn)制度的一體化發(fā)展成為重要議題。2016年1月份國(guó)務(wù)院發(fā)布了《關(guān)于整合城鄉(xiāng)居民基本醫(yī)療保險(xiǎn)制度的意見通知》,提出要按照保基本、全覆蓋、多層次、可持續(xù)的方針,推進(jìn)城鎮(zhèn)居民醫(yī)療保險(xiǎn)制度和新型農(nóng)村合作醫(yī)療制度的整合,在全國(guó)范圍內(nèi)逐步建立起一體化的城鄉(xiāng)居民醫(yī)療保險(xiǎn)制度。截止到2016年底,全國(guó)有2/3的省份對(duì)建立統(tǒng)一的城鄉(xiāng)居民醫(yī)療保險(xiǎn)制度進(jìn)行了總體規(guī)劃部署或者已經(jīng)全面實(shí)現(xiàn)了整合。城鄉(xiāng)醫(yī)療保險(xiǎn)一體化,有利于縮小城市和鄉(xiāng)村的基本醫(yī)療待遇差異,實(shí)現(xiàn)醫(yī)療資源配置的公平,順應(yīng)了我國(guó)統(tǒng)籌城鄉(xiāng)一體化的發(fā)展趨勢(shì)。鄂州市是湖北省城鄉(xiāng)居民醫(yī)療保險(xiǎn)一體化改革的試點(diǎn)城市,從2008年就實(shí)現(xiàn)了城鄉(xiāng)居民醫(yī)療保險(xiǎn)制度的整合,如今已經(jīng)走過(guò)了近10年。在這期間,鄂州市人力資源和社會(huì)保障局在城鄉(xiāng)居民醫(yī)保制度方面做出了不懈努力,不斷創(chuàng)新和完善醫(yī)療保險(xiǎn)管理體制,積累了豐富的經(jīng)驗(yàn)。本文的研究目的是通過(guò)對(duì)鄂州市參加城鄉(xiāng)居民醫(yī)保的居民進(jìn)行問卷調(diào)查和走訪交談,從參保居民的角度出發(fā),以居民醫(yī)保制度的目標(biāo)為條件,以保障居民的健康水平為目的,通過(guò)統(tǒng)計(jì)分析參保居民對(duì)居民醫(yī)保的滿意度,構(gòu)建參保居民對(duì)居民醫(yī)保的滿意度影響因素模型,分析影響因素,對(duì)鄂州市城鄉(xiāng)居民醫(yī)保的進(jìn)一步完善提出政策建議,同時(shí)為國(guó)內(nèi)已經(jīng)整合城鎮(zhèn)居民醫(yī)保和新農(nóng)合的地區(qū)提供借鑒和參考。本文應(yīng)用了武漢大學(xué)社會(huì)保障研究中心關(guān)于"城鄉(xiāng)居民醫(yī)療保險(xiǎn)滿意度調(diào)查"的數(shù)據(jù),從中選取了鄂州市鳳凰街道和古樓街道兩個(gè)城區(qū)以及太和鎮(zhèn)和沼山鎮(zhèn)兩個(gè)鄉(xiāng)鎮(zhèn)共240份問卷進(jìn)行了分析。分析結(jié)果顯示,鄂州市參保居民對(duì)居民醫(yī)保制度總體上比較滿意,其中能夠顯著影響居民對(duì)醫(yī)保滿意度的因素主要有5個(gè),分別是定點(diǎn)醫(yī)療機(jī)構(gòu)的醫(yī)療條件和技術(shù)水平、醫(yī)療工作人員的服務(wù)態(tài)度、醫(yī)療保險(xiǎn)的報(bào)銷比例、醫(yī)療保險(xiǎn)制度可報(bào)銷的病種和藥品范圍以及經(jīng)辦管理機(jī)構(gòu)的工作能力和服務(wù)態(tài)度�；谏衔牡难芯�,本文提出如下政策建議:第一要提高醫(yī)療條件和技術(shù)水平,提升醫(yī)務(wù)人員素質(zhì)。第二要合理確定報(bào)銷比例,與時(shí)俱進(jìn)調(diào)整報(bào)銷范圍。第三是要加強(qiáng)醫(yī)療保險(xiǎn)經(jīng)辦管理機(jī)構(gòu)的工作能力建設(shè)。
[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.
【學(xué)位授予單位】：武漢大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：F842.684

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