城乡居民基本医疗保险满意度及影响因素研究——以上海市为例

Research on Satisfaction and Influencing Factors of Basic Medical Insurance for Urban and Rural Resident——Taking Shanghai as an example

本文对城乡居民医保运行情况进行分析,从参保居民、医疗保险经办机构、医疗器械和药品提供方以及医疗服务机构等多主体视角,应用结构方程模型(SEM)原理构建了城乡居民医保参保人满意度模型,并以上海市为例,对城乡居民满意度的影响因素进行实证分析。结果表明:城乡居民医保参保人的满意度水平介于一般与较满意之间,总体有较大提升空间;经办服务感知、医保政策感知、医疗服务感知、药械感知对参保人满意度均有正向影响;而参保人抱怨对参保人满意度呈负向影响。为此,有针对性地提出优化城乡医疗资源配置、构建合理的城乡居民医保政策调整机制、建立全过程药械市场监管模式、加大对城乡居民医保政策宣传力度等进一步完善城乡居民医保工作的建议。

The differentiation of medical insurance policies for urban and rural residents and the unequal medical opportunities affect the healthy development of China’s medical insurance industry. This paper analyzes the operation of urban and rural residents’ medical insurance, and draws on the American Customer Satisfaction Model(ACSI) to apply structural equation models from the perspectives of insured residents, medical insurance agencies,medical devices and drug providers, and medical service institutions. The(SEM) principle is used to construct the satisfaction model of urban and rural residents’ medical insurance insured persons. Taking Shanghai as an example,the empirical analysis of the influencing factors of urban and rural residents’ satisfaction is carried out. The results show that the satisfaction level of urban and rural residents’ medical insurance participants is between general and satisfactory, and there is a large room for improvement;the service perception, medical insurance policy perception,medical service perception, and drug perception perception are satisfied with the insured. There is a positive impact;and the insured complains that it has a negative impact on the satisfaction of the insured. Therefore, it is proposed to optimize the allocation of medical resources in urban and rural areas, to construct a reasonable adjustment mechanism for medical insurance policies for urban and rural residents, to establish a supervision model for the whole process of drug and drug market, and to increase the publicity of medical insurance policies for urban and rural residents, and to further improve the medical insurance for urban and rural residents.