中国流动人口重复参加基本医疗保险现状及影响因素

Overlapping coverage of basic medical insurance and its influencing factors among migrant populations

目的了解全国流动人口重复参加基本医疗保险现状及影响因素，为制定避免重复参保政策提供依据。方法利用2013年国家流动人口动态监测数据库进行分析，该监测涉及全国31省市，采取PPS抽样，共计调查198795人。结果流动人口重复参加基本医疗保险率为10．9％；重复参保率较高的人群特征为25～29岁（12．9％）和30～34岁（12．8％），教育程度为高中／中专（11．9％）、大专及以上（16．6％），农业户籍（11．0％），跨省流动（11．6％）和省内跨市（10．7％）；外资及中外合资企业员工（31．4％）、国有及国有控股企业员工（23．5％）及机关事业单位员工（21．6％）；多因素logistic回归分析显示，不同年龄、受教育程度、户籍性质、流动范围、单位性质的流动人口重复参加医疗保险率差异均有统计学意义（P〈0．01）。结论雇用单位性质、年龄、教育程度、户口性质及流动范围是影响重复参加基本医疗保险的主要影响因素。

Objective To investigate the prevalence and influencing factors of overlapping coverage of basic medi- cal insurance among migrant populations and to provide evidences for making strategies to prevent duplicated medical in- surance application. Methods Using probability-proportional-to-size sampling （PPS）, 198 795 migrant persons were se- lected from the database of Dynamic Survey on Migrant Population in China - 2013 and surveyed with a questionnaire. Results The rate of overlapping coverage of basic medical insurance was 10. 9% among the participants. The results of univariate and multivariate logistic regression analysis demonstrated that the migrants aged 25 -44 years, with the educa- tion of senior high school or above, employed by a Sino-joint venture company or a foreign-funded enterprise, with a rural residence registry, and migrating between provinces or cities were more likely to have duplicated basic medical insurance application （ all P 〈 0. 05）. Conclusion The main influencing factors for duplicated basic medical insurance application are the character of the employer, age, education background, the place of registered residence, and the geographic scope of migration among the migrant populations.