重庆城乡居民基本医疗保险对糖尿病门诊费用补偿作用研究

A study of imbursement of outpatient expenses for diabetes mellitus under the context of Chongqing urban-rural residents’ medical insurance

目的分析重庆市城乡居民基本医疗保险制度对糖尿病患者门诊费用的补偿作用。方法利用Logistic多元回归模型分析影响患者门诊服务利用的主要因素;按主题框架分析法对访谈资料进行定性分析。结果患者的疾病认知水平与经济状况影响其治疗行为;控制费用的支付政策设计还是因为筹资水平偏低。结论该医保政策已缓解了患者的疾病经济负担,但要提高其经济保障能力,还要适当增加筹资水平及筹集效率、提高慢性病门诊费用支付水平、加强基层医疗机构慢病管理,完善社会保障体系。

Objective To analyze the imbursement of outpatient expenses for diabetes mellitus( DM) patients under the context of cooperative medical insurance for urban-rural residents. Methods The multiple logistic regression model was used to analyze the main factors affecting the utilization of outpatient service,and simultaneously,to analyze qualitatively the interview data with thematic framework analysis. Results A patient's cognition of the disease and financial conditions affected their behaviors of seeking medical service. The cost-control payment policy was designed because of the low level of fund raising. Conclusions Although the scheme has actually alleviated the patients’ financial burden,in order to further improve its capacity of economic security,it is the key to appropriately improve financing level and efficiency,to increase the reimbursement level of outpatient fees,to strengthen the chronic disease management in grassroots medical institutions,and to establish and improve the social security systems.