上海城乡居民医疗保险筹资满意度分析

Analysis on the satisfaction of urban and rural residents in Shanghai with medical insurance financing

目的了解居民对城乡居民医疗保险筹资结构满意度及影响因素,为完善上海城乡居民医疗保险筹资制度提供政策建议。方法采用分层随机抽样的方法,自行设计调查问卷,对386名上海城乡居民医疗保险的参保者进行调查,以了解参保居民对城乡居民医疗保险筹资结构的认知度、满意度和期望度。所得数据采用多元logistic回归方法进行统计,检验收入、年龄、身体健康状况、缴费档次、享受水平对筹资结构满意度的影响,分析上海居民医疗保险的筹资满意度并提出建议。结果上海城乡居民对筹资结构的满意度不高,其中城乡居民的收入、年龄是影响筹资结构满意度的主要因素。结论政府应该基于收入设计筹资方案;保证筹资与待遇相匹配;优化政府财政投入结构;逐步取消个人账户,建立统一的国民健康保险。

Objective To investigate the satisfaction with the medical insurance financing(MIF) among urban and rural residents in Shanghai and its influencing factors and to provide policy recommendations for improving the MIF in this population. Methods In January 2019, 386 urban and rural residents from Shanghai were selected by stratified random sampling as subjects. All of them were covered by medical insurance. A self-designed questionnaire was used to investigate the residents’ awareness, satisfaction, and expectation with MIF. The acquired data was analyzed using the multivariate Logistic regression analysis to determine the effects of income, age, physical health status, payment level, and enjoyment level on the satisfaction of MIF. Corresponding suggestions were proposed. Results The satisfaction with MIF was not high among urban and rural residents in Shanghai, with income and age being the major contributors. Conclusions The local government should design a financing program based on income, ensure that the funding mechanism and the salary is matched, optimize the government’s financial investment structure, and gradually cancel the individual accounts and establish a uniform national health insurance program.