本文選題：城鎮(zhèn)職工基本醫(yī)療保險　切入點：個人賬戶　出處：《沈陽醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究了解沈陽市城鎮(zhèn)職工基本醫(yī)療保險個人賬戶在門診、住院、藥房的利用情況以及參保職工對個人賬戶的認(rèn)知、態(tài)度和建議,以期為政府和醫(yī)療保險管理部門制定個人賬戶的改革政策提供參考資料。方法個人賬戶在門診、住院和藥房的利用情況的數(shù)據(jù)來自于沈陽市醫(yī)療保險機構(gòu)2008-2011年數(shù)據(jù)庫;藥房2012年第一季度的調(diào)查采用整群抽樣的方式抽取360家藥房;參保職工對個人賬戶認(rèn)知的調(diào)查采用多級分層抽樣的方法抽取參保職工7530人。數(shù)據(jù)分析采用動態(tài)數(shù)列、描述性統(tǒng)計分析、χ2檢驗等,并用Excel 2007和SPSS 22.0實現(xiàn)。結(jié)果1.個人賬戶余額:(1)2008-2011年個人賬戶余額和人均個人賬戶余額逐年增長。2009-2011年個人賬戶余額同比增長率分別為35.05%,24.45%和21.54%;人均個人賬戶余額同比增長率為24.75%、29.15%、28.04%。(2)女性參保職工個人賬戶余額和人均個人賬戶余額均少于男性;隨年齡的增長,個人賬戶余額和人均個人賬戶余額均呈"菱形"分布;國家機關(guān)單位賬戶余額相對最少,但人均個人賬戶余額相對最多,企業(yè)單位則相反;年齡大于45歲的人均賬戶余額高于年齡小于45歲的;退休職工中,61-70歲的人均個人賬戶余額和結(jié)余率最高,50歲及以上的退休職工賬戶余額和結(jié)余率最低。2.個人賬戶在門診、住院、藥房支付情況:藥房支出比例最高,住院支出比例最低,門診和住院支出比例均呈逐年上升的趨勢,藥房支出比例逐年下降。3.藥房2012年第一季度調(diào)查:357家藥房的銷售總額為30487.8萬元,醫(yī)�？ǖ匿N售總額為18507.35萬元,后者占前者的60.70%;醫(yī)�？ㄤN售額中,用于藥品的金額為銷售總額的78.61%,其中處方藥占46.86%,非處方藥占53.14%;用于醫(yī)療器械的金額為銷售總額的12.09%,其他則占9.3%。4.參保職工的調(diào)查:(1)認(rèn)知情況:參保職工對個人賬戶劃撥比例了解的比例為46.07%,且不同性別、年齡段、學(xué)歷和地區(qū)之間差異顯著;對其繳納門檻費、繳納自付費用、累計并計息和可以繼承知道的比例分別為40.98%、46.51%、28.12%和26.63%,且郊區(qū)高于市區(qū)。(2)參保職工在醫(yī)院經(jīng)常使用個人賬戶的比例占44.52%,在藥房經(jīng)常使用的比例為62.41%。(3)從總體上看,認(rèn)為在醫(yī)院醫(yī)�？ǚ奖愕谋壤秊�54.82%,現(xiàn)金方便的比例為20.32%。(4)調(diào)查對象中,有41.98%的參保職工關(guān)注個人賬戶余額;13.72%的人會去套現(xiàn)。(5)調(diào)查對象中,建議完全取消個人賬戶的人數(shù)占6.6%,49.01%的人不贊同個人賬戶的支付指定定點醫(yī)療機構(gòu)。結(jié)論沈陽市城鎮(zhèn)職工基本醫(yī)療保險個人賬戶余額呈逐年遞增趨勢;個人賬戶在門診、住院的利用金額逐年增加,在藥房的利用金額逐年減少,但在藥房的利用率最高;沈陽市參保職工對個人賬戶的認(rèn)知率、使用率及關(guān)注度均較低;取消個人賬戶不可取,應(yīng)進(jìn)一步加大個人賬戶的支付范圍,不僅限于指定定點醫(yī)療機構(gòu)。
[Abstract]:The purpose of this study is to understand the personal account of Shenyang city basic medical insurance for urban workers in the outpatient clinic, hospital, pharmacy and the insured workers personal accounts of cognition, attitude and suggestions, in order to develop personal accounts for the government and the medical insurance management department of the reform policies provide reference. Methods of personal accounts in the outpatient, hospital and pharmacy the use of the data from the Shenyang municipal medical insurance institution 2008-2011 years survey database; in the first quarter of 2012, the 360 pharmacy pharmacy from cluster sampling method; investigation of individual account insured workers by cognitive method of multi-stage stratified sampling of insured workers 7530 people. Data were analyzed by using dynamic data, descriptive statistical analysis, chi square the 2 test, and using Excel 2007 and SPSS 22. Results of the 1. personal account balance: (1) 2008-2011 years of personal account balance and personal accounts are Household balance increased year by year.2009-2011 years of personal account balance growth rates were 35.05%, 24.45% and 21.54%; the per capita personal account balance year-on-year growth rate of 24.75%, 29.15%, 28.04%. (2) personal account balance of female insured workers and per capita personal account balance is less than men; with the increase of age, individual account balances and per capita personal account balance showed a "diamond" distribution; state organs and units of account balance is the least, but the per capita personal account balance is relatively the most enterprises opposite; older than 45 years old was higher than the account balance per capita than 45 years old; retired workers, 61-70 per capita personal account balance and the balance of the highest rate, 50 years old and above the retirement account balances and balances the lowest rate of.2. personal accounts in the outpatient clinic, hospital, pharmacy case payment: Pharmacy expenditure ratio is the highest, the lowest proportion of hospitalization expenditure, outpatient and inpatient branch Out of proportion showed a rising trend year by year, the pharmacy expenditure ratio decreased year by year.3. pharmacy survey: the first quarter of 2012 total sales of 357 pharmacies was 304 million 878 thousand yuan, the total sales of health insurance card is 185 million 73 thousand and 500 yuan, which accounted for 60.70% of the former; Medicare card sales, used in medicine for the amount of 78.61% of total sales, including prescription drugs non prescription drugs accounted for 46.86%, accounting for 53.14%; for medical devices for the amount of total sales accounted for 12.09%, other 9.3%.4. employees: (1) cognitive: insured workers on personal accounts allocated proportion solution ratio is 46.07%, and the different gender, age, educational background and significant differences between the area of; pay pay fees threshold, cost, and interest can be inherited and accumulated know the proportions were 40.98%, 46.51%, 28.12% and 26.63% higher than that of urban and suburb. (2) the insured workers in hospitals often use a The account of the proportion of 44.52%, often used in the pharmacy of the ratio of 62.41%. (3) on the whole, that the hospital medical insurance card is convenient for the proportion is 54.82%, the proportion of cash for 20.32%. (4) survey, 41.98% of the insured workers pay attention to individual account balances; 13.72% people will go to cash. (5) survey, the number of proposals completely abolished personal accounts accounted for 6.6%, 49.01% of people do not agree with the personal account payment of designated medical institutions. The conclusion of Shenyang city urban workers' basic medical insurance personal account balance is increasing year by year; personal accounts in the outpatient clinic, the amount of hospitalization increased year by year, the amount decreased year by year in but in the pharmacy pharmacy, the highest utilization rate; the insured workers in Shenyang on the personal account of the cognitive rate, utilization rate and the degree of concern is lower; the abolition of personal accounts is not desirable, should further increase the personal account payment The scope is not limited to designated designated medical institutions.

【學(xué)位授予單位】：沈陽醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R197.1;F842.684

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