我国现行医保制度问题诊断及影响因素分析

Analysis on the Current Medical Insurance System and Its Influencing Factors in China

目的:对我国现行医保制度问题进行诊断分析并探讨其影响因素。方法:采用分层整群抽样方法,从我国东、中、西部各地区共抽取1650名医保相关人员开展问卷调查,运用一般性描述分析、x^2检验和Logistic回归分析等方法分析医保制度问题的严重程度及其影响因素。结果:影响我国现行医保制度问题严重程度的因素为医保整合改革问题的严重程度(OR=2.476)、文化程度(OR=1.834)、医保制度筹资设计的合理性(OR=1.431)、基金运行管理问题的严重程度(OR=1.424)。结论:医保制度改革应重点围绕医保制度设计、运行和改革过程中存在的突出问题,完善相关制度设计,保证医保基金安全、可持续运行,制定明确统一的医保整合政策,促进整合改革顺利进行。

Objective： To analyze the problem relating to current health insurance system in China and its influencing factors. Methods： A questionnaire survey was conducted with stratified cluster sampling method in the eastern, central and western regions of China and 1 650 respondents related to health care were interviewed. The results were analyzed by general descriptive analysis, chi square test and multivariate logistic regression. Results： The results of logistic regression analyses showed that the influencing factors were the seriousness of the problem in medical insurance integration reform（OR=2.476）, educational attainment（OR=1.834）, the rationality of financing design in medical insurance（OR=1.431） and the severity of the problem in fund operation and management（OR= 1.424）. Conclusion： The reform of the medical insurance system should be focused on the problems in the design, operation and reform of the existing medical insurance system. Improving the relevant system design, as well as ensuring the safe and sustainable operation of the medical insurance fund, formulating a unified medical insurance integration policy and promoting the progress of the reform.