本文關(guān)鍵詞：新疆城鄉(xiāng)參保居民對(duì)醫(yī)保滿意度的對(duì)比研究　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 城鄉(xiāng)醫(yī)保 滿意度 影響因素 對(duì)比

【摘要】：目的:分析新疆自治區(qū)城鄉(xiāng)居民對(duì)城鎮(zhèn)居民基本醫(yī)療保險(xiǎn)和新型農(nóng)牧區(qū)合作醫(yī)療制度的滿意度情況,明確城鄉(xiāng)參保居民對(duì)醫(yī)保的滿意度是否存在差異,并找到差異來源。提供完善醫(yī)保制度的建議,并為新疆自治區(qū)整合城鄉(xiāng)醫(yī)保制度的實(shí)施提供參考意見。方法:采用多階段隨機(jī)抽樣的方法,在新疆城鄉(xiāng)地區(qū)抽取調(diào)查人群,通過發(fā)放調(diào)查問卷的方式進(jìn)行現(xiàn)場(chǎng)調(diào)查。從醫(yī)保認(rèn)知、定點(diǎn)醫(yī)療機(jī)構(gòu)、醫(yī)保補(bǔ)償機(jī)制、經(jīng)辦機(jī)構(gòu)等維度進(jìn)行城鄉(xiāng)醫(yī)保滿意度對(duì)比分析,并使用多元線性回歸方法分析城鄉(xiāng)醫(yī)保滿意度的影響因素。結(jié)果:在城鄉(xiāng)醫(yī)保滿意度方面,新疆自治區(qū)城鄉(xiāng)參保居民在選擇就診時(shí)主要以村衛(wèi)生室、鄉(xiāng)鎮(zhèn)衛(wèi)生院以及社區(qū)醫(yī)院等基層醫(yī)療機(jī)構(gòu)為主;城鄉(xiāng)參保居民在醫(yī)保對(duì)家庭的重要性方面的滿意度存在差異(χ2=27.122,p0.001),參合農(nóng)民滿意度較高;城鄉(xiāng)參保居民對(duì)醫(yī)保制度中的補(bǔ)償類型、補(bǔ)償范圍、起付線、補(bǔ)償標(biāo)準(zhǔn)、補(bǔ)償比例和報(bào)銷程序的認(rèn)知存在統(tǒng)計(jì)學(xué)差異(p0.05),城鎮(zhèn)認(rèn)知度較低;區(qū)域衛(wèi)生資源配置不合理,基層醫(yī)療機(jī)構(gòu)診療水平、儀器設(shè)備和就醫(yī)環(huán)境的滿意度較低;各級(jí)定點(diǎn)醫(yī)療機(jī)構(gòu)的就醫(yī)方便性較差,城鎮(zhèn)尤甚;除自治區(qū)醫(yī)院外,各級(jí)定點(diǎn)醫(yī)療機(jī)構(gòu)的醫(yī)務(wù)人員服務(wù)態(tài)度滿意度較低,城鎮(zhèn)尤甚;城鄉(xiāng)參保居民均認(rèn)為個(gè)人繳費(fèi)水平偏高且存在差異(χ2=9.554,p=0.049),城鎮(zhèn)尤甚;各級(jí)定點(diǎn)醫(yī)療機(jī)構(gòu)的起付線和住院報(bào)銷比例合理性不高,尤其是地級(jí)、自治區(qū)級(jí)醫(yī)院的合理性明顯地區(qū)鄉(xiāng)鎮(zhèn)、縣級(jí)醫(yī)院,主要表現(xiàn)為地級(jí)、自治區(qū)級(jí)醫(yī)院起付線較高,而報(bào)銷比例較低,且城鎮(zhèn)尤甚(p0.05);城鄉(xiāng)參保居民對(duì)醫(yī)保報(bào)銷范圍的藥品目錄(t=4.310,p0.001)、診療項(xiàng)目(t=5.343,p0.001)和服務(wù)設(shè)施項(xiàng)目(t=5.091,p0.001)滿意度存在差異,且農(nóng)村明顯高于城鎮(zhèn);城鄉(xiāng)參保居民均認(rèn)為報(bào)銷手續(xù)繁瑣,且"要求提供的資料太多"、"不能即時(shí)結(jié)報(bào)"、"不能及時(shí)報(bào)銷"是報(bào)銷過程中遇到的主要問題。在城鄉(xiāng)醫(yī)保滿意度影響因素方面,醫(yī)保政策中的籌資與補(bǔ)償標(biāo)準(zhǔn)以及經(jīng)辦機(jī)構(gòu)是影響城鄉(xiāng)居民對(duì)醫(yī)�？傮w滿意度的主要因素。其中,醫(yī)保對(duì)家庭的重要性、報(bào)銷手續(xù)以及個(gè)人繳費(fèi)水平這3個(gè)因素均影響城鄉(xiāng)醫(yī)保滿意度,此外,醫(yī)保目錄中的診療目錄和服務(wù)設(shè)施目錄分別是影響城鄉(xiāng)醫(yī)保滿意度的重要因素。結(jié)論:應(yīng)提高城鄉(xiāng)醫(yī)保宣傳力度,提高認(rèn)知水平;合理規(guī)劃區(qū)域衛(wèi)生資源配置,推動(dòng)優(yōu)質(zhì)資源下沉;完善就診信息化建設(shè),簡(jiǎn)化就醫(yī)流程,提高就醫(yī)方便性;建立技術(shù)培訓(xùn)考核機(jī)制,提升醫(yī)務(wù)人員服務(wù)態(tài)度;提高補(bǔ)償機(jī)制的合理性,個(gè)人繳費(fèi)水平區(qū)分對(duì)待,更新擴(kuò)容醫(yī)保目錄,降低地級(jí)、自治區(qū)級(jí)醫(yī)療機(jī)構(gòu)起付線的同時(shí)提高報(bào)銷比例;統(tǒng)一醫(yī)保管理部門,整合經(jīng)辦機(jī)制,簡(jiǎn)化報(bào)銷手續(xù),提升服務(wù)能力;增加籌資渠道,增強(qiáng)籌資能力。
[Abstract]:Objective: to analyze the satisfaction of urban and rural residents in Xinjiang autonomous region cooperation of the basic medical insurance for urban residents and the new medical system in agricultural and pastoral areas, clear insurance and rural residents satisfaction on health care and whether there are differences, and find the differences. Provide the perfect health care system to provide reference opinions and suggestions for the integration of urban and rural medical insurance system in Xinjiang autonomous region. Methods: using multistage random sampling method, sampling survey in Xinjiang population in urban and rural areas, were investigated through questionnaire. From the cognitive health insurance designated medical institutions, medical insurance, compensation mechanism, agency dimension analysis of urban and rural health care satisfaction comparison, influencing factors and use the method of multiple linear regression analysis of urban and rural health care satisfaction results: in the urban and rural health care satisfaction, the Xinjiang autonomous region of urban and rural residents in the selection of the insured hospital mainly in the village Health room, mainly in primary health care institutions of township hospitals and community hospitals; health care insurance and rural residents satisfaction in the importance of family differences (2=27.122, p0.001), farmers satisfaction is higher; insurance and rural residents of the health care system of the type of compensation, compensation scope, compensation standard, pay line, there was different proportion of compensation and Reimbursement Program (P0.05), the cognition of urban low awareness; irrational allocation of the regional health resources, the level of diagnosis and treatment of primary health care institutions, medical equipment and environmental satisfaction degree is relatively low; all levels of medical institutions for medical treatment to facilitate the poor, especially in towns; in addition to the autonomous region outside the hospital, medical staff service attitude the satisfaction levels of medical institutions is low, especially in towns; insurance and rural residents are of the view that the level of individual contributions is high and there is a difference (2=9.554, p=0.049), especially in the town; Designated medical institutions the deductible and reimbursement of hospitalization rationality is not high, especially in cities, villages and towns, autonomous region hospital area was the rationality of county-level hospitals, mainly for prefecture level, autonomous district hospitals and higher deductibles, reimbursement ratio is low, and the town especially (P0.05); insurance and rural residents of Medicare reimbursement drug list the range of (t=4.310, p0.001), (t=5.343, p0.001) treatment project and service facilities project (t=5.091, p0.001) satisfaction difference was significantly higher than that of urban and rural residents of both urban and rural areas; think reimbursement cumbersome, and the requested data is too much "," no immediate settlement "," not timely reimbursement "is the main problems encountered in the process of reimbursement. In the urban and rural health care satisfaction factors, financing and compensation standard in medical insurance policy and the agencies are the main influence on the overall satisfaction of medical insurance for urban and rural residents Factors. Among them, the importance of family health care, these 3 factors and the level of personal payment reimbursement procedures affect urban and rural health care satisfaction, in addition, the medical health insurance directory directory and directory services are the important factors affecting urban and rural health care satisfaction. Conclusion: we should improve the urban and rural health care propaganda, improve the cognitive level of area; the allocation of health resources reasonably, promote quality resources to sink; improve hospital information construction, simplify the medical treatment process, improve medical convenience; establishment of technical training and evaluation mechanism, improve service attitude of medical personnel; improve the rationality of the compensation mechanism, the level of individual contributions differently, updating the directory, reduce the expansion of Medicare level, regional level medical institutions pay line at the same time improve reimbursement; unified medical insurance management department, the integration mechanism of handling, simplify reimbursement procedures, improve service ability; increase financing channels, Enhance the ability to raise funds.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R197.1;F842.684

【相似文獻(xiàn)】

相關(guān)期刊論文 前8條

1 陳儉;郝玲妹;;寧波市鎮(zhèn)海區(qū)農(nóng)村參保居民血糖、血脂及尿酸水平調(diào)查[J];上海預(yù)防醫(yī)學(xué);2011年10期

2 劉熙林;;青島老年參�；颊咴囆袑Ｗo(hù)[J];中國(guó)醫(yī)療保險(xiǎn);2011年08期

3 ;馬鞍山市 醫(yī)保新政呈三亮點(diǎn)[J];中國(guó)醫(yī)療保險(xiǎn);2009年08期

4 ;重慶市人民政府辦公廳關(guān)于進(jìn)一步完善城鄉(xiāng)居民合作醫(yī)療保險(xiǎn)制度的指導(dǎo)意見[J];重慶市人民政府公報(bào);2010年20期

5 玖文;;居民醫(yī)保:在突破中提速[J];中國(guó)醫(yī)療保險(xiǎn);2009年02期

6 ;濟(jì)南市 出臺(tái)明年醫(yī)保新政 保險(xiǎn)上限提高至9萬(wàn)[J];中國(guó)醫(yī)療保險(xiǎn);2009年10期

7 ;在藥店購(gòu)買的藥品該不該報(bào)銷[J];首都醫(yī)藥;2008年21期

8 ;[J];;年期

相關(guān)重要報(bào)紙文章 前10條

1 記者 李志廷;我區(qū)50歲以上參保居民將免費(fèi)體檢[N];寧夏日?qǐng)?bào);2014年

2 王紅;參保居民月底前快繳費(fèi)[N];鄭州日?qǐng)?bào);2007年

3 記者 崔曉玲邋實(shí)習(xí)生 鄭陽(yáng)洋;參保居民住院最高報(bào)銷1.6萬(wàn)[N];昆明日?qǐng)?bào);2007年

4 記者 張蔚 通訊員 周日任;縣城參保居民可“市內(nèi)定點(diǎn)”[N];柳州日?qǐng)?bào);2008年

5 本報(bào)記者 張克果　叢琳娜;參保居民緣何“扎堆”這些醫(yī)院[N];威海日?qǐng)?bào);2008年

6 通訊員車積儉 孫玉娥;湖北航天醫(yī)院 啟動(dòng)城鎮(zhèn)參保居民體檢[N];孝感日?qǐng)?bào);2008年

7 記者 馬秀之;我市對(duì)城鎮(zhèn)參保居民首次進(jìn)行慢性病門診鑒定檢查[N];格爾木日?qǐng)?bào);2009年

8 本報(bào)通訊員 王晨琰;吳堡全面實(shí)施城鄉(xiāng)居民社會(huì)養(yǎng)老保險(xiǎn)制度[N];榆林日?qǐng)?bào);2010年

9 記者 王雪威 通訊員 梁靜;200多萬(wàn)參保居民將受益[N];河北日?qǐng)?bào);2012年

10 記者 鐘蘭花 通訊員 朱益民;參保居民不用繳費(fèi)即可享受大病保險(xiǎn)[N];紹興日?qǐng)?bào);2012年

相關(guān)碩士學(xué)位論文 前2條

1 李杰;新疆城鄉(xiāng)參保居民對(duì)醫(yī)保滿意度的對(duì)比研究[D];北京中醫(yī)藥大學(xué);2017年

2 李子芹;浙江省城鎮(zhèn)居民基本醫(yī)療保險(xiǎn)制度研究[D];浙江財(cái)經(jīng)學(xué)院;2012年

，

本文編號(hào)：1380118