北京市某区农民工参加医疗保险的现状和需求研究

Research on the current situation and needs of migrant workers to participate in medical insurance in one district of Beijing

目的了解北京市某区农民工参加医疗保险的现状和需求。方法于2016年1~2月采用整群抽样的方法抽取北京市某区来京时间超过6个月的144名农民工进行问卷调查,调查内容包括参加医疗保险的现况和参保意愿等。于2016年2月利用目的抽样的方法选取6名农民工进行定性访谈,访谈内容包括参加医疗保险的情况和对医保的期望等。结果问卷调查结果显示,43人（29.9%）在北京有医保,87人（60.4%）在家乡有医保;相比较北京的医保,只有12.6%的家乡医保能够报销门诊费用;最希望能够报销的三类项目依次为大病医保（74.3%）、门诊（61.1%）和住院（57.6%）。定性访谈结果显示,多数农民工以临时工身份在京务工,缺乏必要的医疗保险;参保首选新型农村合作医疗;对现有医保制度缺乏了解;根据病情和医保所在地决定就诊的方式。结论政府应强化企业为农民工购买医疗保险的责任,并加快医疗保险的转移衔接,为农民工提供健康保障。

Objective To study the current situation and needs of migrant workers in one district of Beijing to participate in medical insurance. Methods From January to February in 2016, 144 migrant workers were selected by cluster sampling method who had stayed more than six months in one district of Beijing. The survey focused on the current situation and needs of migrant workers to participate in medical insurance. Moreover, in February 2016, 6 migrant workers were selected by purposive sampling method to attend a qualitative interview including the situation of participating in medical insurance, the expectations to medical insurance, and so on. Results The investigation indicated that 43（29.9%） migrant workers participated in medical insurance in Beijing, and 87（60.4%） migrant workers participated in medical insurance in hometown. Compared with medical insurance of Beijing, only 12.6% medical insurance of hometown could reimburse outpatient service. The top three which migrant workers expected to be reimbursed were the fees of catastrophic medical insurance（74.3%）, outpatient service（61.1%） and hospital service（57.6%）. Qualitative interview showed that most of the migrant workers as temporary workers lived in Beijing and lacked of necessary medical insurance and preferred to the new rural cooperative medical system as first choice. They were not clear about the existing system of medical insurance. They decided to see a doctor based on the state of illness and their medical insurance situation. Conclusion The government should strengthen the responsibility of enterprises to purchase medical insurance for migrant workers, and accelerate the transfer of medical insurance, to provide health care protection for migrant workers.