西部地区城镇居民基本医疗保险的认知、参保与利用研究:基于广西桂林市的调查

Studying on the residents' awareness,participation and utilization of urban resident medical insurance in Western China based on survey in Guilin City

目的:了解西部地区社区居民对城镇居民基本医疗保险的认知、参保与利用情况,为完善医疗保障制度提供参考依据。方法:采用分层整群随机抽样的方法,2015年9-12月对广西桂林市976名社区居民进行现场问卷调查。结果:社区居民对城镇居民基本医疗保险制度了解的比例为30.0%,参保率为72.2%,参保居民中仅33.2%的利用过保险;Logistic回归显示,年龄、文化程度、婚姻状况、职业、性别以及对保险制度合理性的判断是影响社区居民是否参加城镇居民基本医疗保险的主要因素(P<0.05),年龄、文化程度、家庭人均月收入、对城镇居民基本医疗保险制度和报销比例的了解程度是影响社区居民利用城镇居民基本医疗保险的重要因素(P<0.05)。结论:社区居民对城镇居民基本医疗保险的认知情况较差,参保率偏低,对保险的利用明显不足,应加强基本医疗保险政策的宣传力度,降低报销缴费水平,提高报销比例,不断扩大保险的项目覆盖范围,鼓励商业医疗保险进入医保体系。

Objective To understand the residents＂ awareness, participation and utilization ot urban resident medical insur- ance in Western China, and provide references for improving medical insurance system. Methods 976 cases of residents were cho- sen with stratified cluster sampling from communities of Guilin City from September to December in 2015, and surveyed with ques- tionnaire. Results The residents＇ awareness rate of urban resident medical insurance was 30.0%. And the rate of participating was 72.2% , only 33.2% of which had utilized the insurance. Multi-factor kogistic regression showed that factors of age, educa- tion, marital status, occupation, gender and judgment on reasonability of insurance were the main factors to influence the partici- pation of the insurance （ P 〈 0.05 ）. And the factors of age, education, family monthly income, awareness of medical insurance system were important factors to influence the utilization of medical insurance （ P 〈 0.05 ）. Conclusion The residents＇ awareness of urban resident medical insurance was poor, wstem, reduce the proportion of financing, increase the proportion of reimbursement, expand the coverage of medicalith lower participation rate and lower utilization rate. It is suggested to strengthen the propaganda on medical insurance sy insurance, and encourage the access of commercial medical insurance.