本文選題：民辦高校學生 + 衛(wèi)生服務需求�。� 參考：《南華大學》2013年碩士論文

【摘要】：目的 探索湖南省民辦高校學生衛(wèi)生服務需求、利用和醫(yī)療保障的現(xiàn)狀，及其影響因素，找出民辦高校學生醫(yī)療保障存在的問題，為制定促進民辦高校學生健康的醫(yī)療保障制度與措施提供依據(jù)。 方法 采用整群隨機抽樣方法，在湖南省隨機抽取四所民辦高校，包括兩所本科院校和兩所�？茖W校，然后再在每所學校各個年級隨機抽取3個班級共45個班級2438名學生，利用民辦高校學生衛(wèi)生服務利用和醫(yī)療保障調(diào)查表，以班為單位調(diào)查民辦高校學生的衛(wèi)生服務需求、利用和醫(yī)療保障現(xiàn)狀及其影響因素。 結果 1、民辦高校學生的衛(wèi)生服務需求及其影響因素民辦高校學生兩周患病率為15.92%，半年慢病患病率為2.73%；各民辦高校之間、本科與�？茖W生間、不同家庭經(jīng)濟狀況的學生的兩周患病率差異無統(tǒng)計學意義（P0.05）；一年級學生兩周患病率高于其余年級（P0.05），女生兩周患病率高于男生（P=0.006）；城鎮(zhèn)來源的學生兩周患病率高于農(nóng)村（P=0.008），體育鍛煉對學生兩周患病率有影響（P=0.008），經(jīng)常體育鍛煉的學生兩周患病率最低，從不鍛煉的學生兩周患病率最高，，不良生活習慣的學生兩周患病率高于生活習慣良好的學生（P=0.000）；僅14.55%的學生經(jīng)常參加體育鍛煉，有35.05%的學生從不參加體育鍛煉，有不良生活習慣的學生的比例占65.92%；年級、學歷層次、城鎮(zhèn)與農(nóng)村來源、家庭經(jīng)濟狀況對學生半年慢病患病率均無影響（P0.05）。 2、民辦高校學生醫(yī)療衛(wèi)生服務利用及其影響因素民辦高校學生兩周患病就診率為39.9%，學生一年住院率為4.23%，需要住院而未住院率為2.29%；醫(yī)學院校學生兩周患病就診率低于非醫(yī)學院校（P=0.008），專科學生的就診率高于本科院校（P=0.002）；女生就診率高于男生（P=0.043）；來源于城鎮(zhèn)學生就診率高于農(nóng)村的（P=0.030）；家庭收入對學生兩周患病就診率有影響（P=0.024），人均收入越低，學生就診率越低。本、�？茖W生兩周患病首診醫(yī)療機構的選擇不同（P=0.000），本科學生兩周患病首診在校醫(yī)務室和社區(qū)衛(wèi)生服務中心的比例69.1%，兩所�？茖W校沒有醫(yī)務室，學生兩周患病首診主要選擇私人診所和社區(qū)衛(wèi)生服務中心。 學生兩周患病的自我醫(yī)療率為33.1%，醫(yī)科類學生自我醫(yī)療率高于其他類的學生（P=0.036），來源于農(nóng)村的學生自我醫(yī)療率高于來源于城鎮(zhèn)的學生（P=0.004）；年級、性別、家庭收入、生活習慣、體院鍛煉等與學生兩周患病自我醫(yī)療率無關（P0.05）；29.6%的兩周患病學生未進行任何治療，未診的最主要原因是經(jīng)濟困難，其次是自感病輕不需要治療，醫(yī)院服務差、技術差也是學生不就診的一個重要原因，學生對學校醫(yī)療服務的滿意度很差。 3、民辦高校學生醫(yī)療保障現(xiàn)狀民辦高校學生的城鎮(zhèn)居民醫(yī)保和意外傷害保險的參保率分別為96.7%和94.4%，但學生對自己參保的知曉率較低，分別為59.7%和58.8%；各校學生的參保率無差異（P0.05），本科學生對醫(yī)保和意外傷害險的知曉率稍高于�？茖W生（P0.05）；學生對學校的醫(yī)療保障制度、措施的知曉率僅為42.3%，認為學校無任何醫(yī)療保障制度、措施，即使有也沒有起任何作用。 民辦高校學生不愿參加城鎮(zhèn)居民醫(yī)保和意外傷害保險比例高達30%以上，民辦高校學生參加城鎮(zhèn)居民醫(yī)保和意外傷害保險具有一定的強制性。學生不愿參保的原因主要是對醫(yī)保政策不了解，其次是投保費高、報銷比例低、作用不大，理賠麻煩也是學生不愿參保的原因之一。 民辦高校8.7%參保學生醫(yī)療費用得到了部分報銷，報銷過住院費的學生占參保人數(shù)的4.3%，報銷過門診費的占4.6%，兩者都報銷過占1.7%。 結論 1、湖南省民辦高校學生患病后就診率和住院率偏低，民辦學校應加強學生醫(yī)療保健意識教育，引導正確的就醫(yī)行為。 2、湖南省民辦高校的基本醫(yī)療服務、預防保健、健康教育匱乏，醫(yī)療設施缺少，學校應增加醫(yī)療衛(wèi)生服務投入，建立校醫(yī)務室及改善校醫(yī)務室的條件，并將校醫(yī)務室建成為社區(qū)衛(wèi)生服務中心（站）。 3、湖南省民辦高校學生已納入國家基本醫(yī)療保障范疇，建立了多種醫(yī)療保障體系。但民辦高校學生的參保意識不強，學生對醫(yī)療保障制度與措施的知曉率低，學生參保基本上是學校強制性，參保利用率低，學校應采用多種方式，提高大學生的自愿參保率。
[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 .
【學位授予單位】：南華大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R197;G647.8

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