基于SEM的新型农村合作医疗制度保障能力影响因子分析

Impact factors analysis on medical care security capability of new rural cooperative system based on structural equation model

以利益相关者理论为基础,界定了新型农村合作医疗制度(简称"新农合")保障能力的范围及概念;以陕西省687户参加新农合的农民为样本调研数据,运用结构方程模型(SEM)对影响农民对新农合制度保障能力评价的影响因子进行了分析。结果表明:定点医疗机构保障能力、政府机构保障能力、经办机构保障能力对新农合制度整体保障能力具有均有显著正向影响;定点医疗机构条件、医护人员技术水平、医疗设备保障是影响新农合整体保障能力的关键因素;改善定点医疗机构的软硬件条件和新农合微观运行机制是满足参合农户医疗服务强弹性需求的措施。

Based on stakeholder theory,687 farmers who participated New Rural Cooperative Medical System(NRCMS)in Shannxi province were selected as sample data for analyzing the medical-care security capabilities and impact factors of NRCMS by structural equation model(SEM).The data analysis showed that the support capability of designated medical institutions,government and the cooperative medical service agencies had significantly positive effect on the whole support ability of the NRCMS.Medical institutions'environment,medical staff skill and medical equipment condition were key factors that affected the whole support ability of NRCMS.Improving the software and hardware conditions and the micro-operating mechanism would be effective measures to meet the peasants'strong elasticity demand for medical service.