福州乡镇家长对儿童参保满意度及其影响因素分析

Parents′ satisfaction to their children′s participation in basic medical insurance and its influencing factors in towns of Fuzhou municipality

目的了解福建省福州乡镇儿童家长对儿童参加基本医疗保险的满意情况及其影响因素。方法于2017年8—10月,采用分层抽样法抽取福州6个乡镇483名≤12岁儿童家长为调查对象,运用logistic回归分析主要影响因素。结果参保儿童家长对儿童参保的满意率为37.39%;有序logistic回归分析结果显示,孩子年龄介于1~3岁(OR=0.256,95%CI=0.116~0.563)、家长职业为企业员工(OR=0.416,95%CI=0.206~0.842)、月收入<2 000元或2 000元~组(OR=0.095、0.145,95%CI=0.015~0.604、0.033~0.625)、家庭年收入<6万元或6万元~组(OR=0.062、0.152,95%CI=0.006~0.615、0.025~0.933)、儿童患病时首选省级或市级医院作为就诊机构(OR=0.102,95%CI=0.020~0.522)是影响家长对儿童参保满意度的负面因素(P <0.05);首选就医机构为县级医疗机构、乡镇卫生院及社区卫生服务站(OR=4.332、2.759、4.545,95%CI=1.687~11.120、1.158~6.575、1.330~15.532)为影响家长对乡镇儿童参保满意度的积极因素(P <0.05)。结论乡镇儿童家长对儿童参保的满意度不理想,影响满意度的主要因素包括孩子年龄、家长职业、月收入、家庭年收入和患病时首选的就诊医院等。

Objective To investigate the status and impact factors of satisfaction of the parents to their children′s basic medical insurance in towns of Fuzhou municipality, Fujian province. Methods We recruited 483 parents of the children aged ≤ 12 years in 6 towns of Fuzhou municipality using stratified cluster random sampling for a questionnaire survey between August and October 2017. Univariate analysis and multivariate logistic regression analysis were adopted in the study. Results For all the parents, the overall rate of satisfaction to their children′s participation in basic medical insurance was 37.39%. Ordinal logistic regression analysis revealed that significant hindering factors for the parents ′ satisfaction included having a one to three years old child（odd ratio [OR] = 0.256,95% confidence interval [CI]： 0.116-0.563）,being an employee of an enterprise（OR = 0.416,95% CI： 0.206-0.842）, having a monthly income of less than 2 000 RMB yuan（OR = 0.095, 95% CI： 0.015-0.604） or 2 000-3 999 yuan（OR = 0.145, 95% CI： 0.033-0.625）, having a family annual income of less than 60 000 yuan（OR = 0.062, 95% CI： 0.006-0.615） or 60 000-79 999 yuan（OR = 0.152, 95%CI：0.025-0.933）, selecting hospitals at municipality level or higher as the initial institutions when their children requiring medical service（OR = 0.102, 95% CI： 0.020-0.522）; while, the satisfaction-promoting factors were selecting medical institutions at county level（OR = 4.332, 95% CI： 1.687-11.120）, township level（OR = 2.759, 95% CI： 1.158-6.575）, and community level（OR = 4.545,95% CI： 1.330-15.532） as the initial institutions when their children requiring medical service. Conclusion The parents in towns of Fujian province were not well satisfied to their children＇s participation in basic medical insurance and the parents′ satisfaction are mainly influenced by their children′s age,occupation,personal monthly income,family income, and the selection of initial medical institutions when their children requiring medical service.