2015年广州高校大学生参加城镇居民基本医疗保险现状及影响因素分析

Current status of basic medical insurance for urban residents and its influencing factors among undergraduates in Guangzhou,2015

目的了解广州高校大学生参加城镇居民基本医疗保险的现状及影响因素,为改善大学生参加城镇居民基本医疗保险的现状提供科学依据。方法 2015年11月以广州市5所高校1 690名大学生作为调查对象,采用自行设计的问卷对大学生参加城镇居民基本医疗保险的情况及可能的影响因素进行分析。结果广州高校大学生参保率为83.4%,男生为80.9%,女生为84.7%;大学生加入城居医保的途径以学校相关部门宣讲(61.5%)为主;参加城居医保的原因以生病时减轻家里负担(82.1%)为主;未参加城居医保的原因以报销手续繁杂、异地报销难(62.1%)为主;多因素logistic回归分析结果发现:港澳台及其他地区(OR=0.382,95%CI:0.252~0.578)、就诊首选大型医院和校外小诊所(OR=0.379、0.379,95%CI:0.257~0.560、0.263~0.545)的大学生参保率低(均P<0.05),大二、大三、大四(OR=1.998、2.677、2.575,95%CI:1.297~3.078、1.701~4.212、1.667~3.976)、医药类专业(OR=1.613,95%CI:1.108~2.349)、自评身体健康状况好(OR=1.910,95%CI:1.125~3.243)、对医保政策了解但不多和非常了解(OR=8.281、2.892,95%CI:4.946~13.864、1.356~6.168)、对校医院满意(OR=1.896,95%CI:1.090~3.202)的大学生参保率高(均P<0.05)。结论广州高校大学生的参保率还未达到100%的要求,高校应加强医保知识的宣传教育工作,医保相关部门应简化报销和转诊流程,校医院须改善医疗水平和服务质量,以达到100%的参保水平。

Objective To investigate the current situation of basic medical insurance for urban residents and its influencing factors among undergraduates in Guangzhou so as to provide scientific evidence for improving its current situation. Methods A total of 1,690 undergraduates from 5 universities in Guangzhou in November, 2015 were selected as the research objects. A self-designed questionnaire was used to survey and analyze the situation of basic medical insurance for urban residents and its possible influencing factors among the undergraduates. Results The rate of joining the insurance in the undergraduates was 83.4%, with 80.9% in males and 84.7% in females. The main way of joining the insurance of the undergraduates was the propaganda from relevant departments of universities （61.5%）. The main reasons for joining and declining the insurance were reducing family burden （82.1%） and complicated reimbursement process and difficult reimbursement for nonlocal medical expenses （62.1%） respectively. Multi-factor logistic regression analysis showed that undergraduates from Hong Kong, Macao, Taiwan and other areas （ OR=0.382, 95%C1：0.252-0.578） and ones with initial treatment in larger hospitals and privated clinics （OR=0.379, OR=0.379, 95%CI：0.257-0.560, 95%CI：0.263-0.545） had a lower rate of joining the insurance （all P〈0.05） , while sophomores, juniors and seniors （ OR= 1.998, OR=2.677, OR=2.575, 95%CI： 1.297- 3. 078, 95%CI： 1.701-4. 212, 95%CI： 1.667-3.976）, medical and pharmaceutical majors （ OR = 1.613, 95%CI： 1.108-2.349）, undergraduates with good health condition （OR= 1.910, 95%CI：1.125-3.243）, ones known a little or well about insurance policy （OR= 8.281, OR =2.892, 95%CI：4.946-13.864, 95%CI： 1.356-6.168） and ones satisfied with the university hospital （OR= 1.8%, 95%CI： 1.090-3.202） had a higher rate of joining the insurance （ all P〈0.05）. Conclusions The rate of joining the insurance of the undergraduates in Guangzhou do not meet the 100% requirement. Universities should intensify educational propaganda for medical insurance knowledge. The government should simplify reimbursement and transferring process and university hospitals should improve the medical level and quality of service in order to reach the goal of 100% joining the insurance.