城乡居民基本医疗保险小学生决策人认知及其影响因素的多重对应分析

Multiple Correspondence Analysis on the Cognition and the Influencing Factors of Decision Makers of Primary School Students′ Basic Medical Insurance for Urban and Rural Residents

目的探索小学生决策人对城乡居民基本医疗保险的认知及其影响因素,为进一步提高居民对城乡居民基本医疗保险的认知,完善长沙市城乡居民基本医疗保险提供参考。方法采用三阶段分层随机整群抽样方法在长沙市随机抽取8所小学共2684名小学生,对小学生家庭中基本医疗保险最重要的决策人进行问卷调查。通过聚类分析、有序logistic回归分析和多重对应分析了解小学生决策人城乡居民基本医疗保险认知的主要影响因素。结果小学生决策人对长沙市城乡居民基本医疗保险认知均分为5.23分,尚有较大提升空间;有序logistic回归分析结果显示:小学生决策人的性别、文化程度、小学生过去一年是否已经参保、小学生户口是否在长沙是影响小学生决策人城乡居民基本医疗保险认知的主要因素;多重对应分析结果显示:女性、文化程度越高、小学生户口在长沙、小学生过去一年已经参保的决策人,其城乡居民基本医疗保险认知更高。结论为提高城乡居民基本医疗保险认知,积极引导未参保者参保及合理利用医疗资源,相关部门应该加强对小学生决策人的宣传,尤其是小学生决策人为男性、文化程度较低、其家中小学生户口不在长沙、小学生过去一年没有参保的人群。

Objective To explore the cognition and its influencing factors of the decision makers of primary school pupils on Basic Medical Insurance for Urban and Rural Residents(URRBMI),so as to provide evidences for policy improvement.Methods A three-stage stratified random cluster sampling design was adopted.A total of 2684 primary school students were randomly selected in 8 primary schools of Changsha city,the main decision makers about their URRBMI in their family were asked to finish the questionnaire.Clustering analysis,ordinal logistic regression analysis and multiple correspondence analysis were used to explore the influencing factors of the decision makers'cognition on URRBMI.Results The mean score of the decision makers'cognition about URRBMI in Changsha was 5.23,which needs to be improved.The result of ordinal logistic regression analysis showed that the gender,education level of the decision makers,whether the pupils have been insured in last year,and whether the pupils'registered residence was Changsha were the major factors that influencing the decision makers'cognition.The result of multiple correspondence analysis demonstrated that the decision makers were female,the higher education level of the decision makers,the pupils have been insured in last year,the pupils'registered residence was Changsha were related to the higher cognition about URRBMI.Conclusion In order to improve the cognition of URRBMI and guide the uninsured to participate in the insurance and make rational use of health care resources,policy advocacy need to be improved,especially for those with lower education,without formal residency rights in Changsha,uninsured in the past year,and male.