60岁以上人口医疗保险普及率研究——以眉山市仁寿县为例

Investigation on the Penetration Rate of Medical Insurance among the Population over 60 Years Old—Taking Renshou County, Meishan City as an Example

目的:了解眉山市仁寿县60岁以上人口医疗保险普及率现状,分析其影响因素,为政府及相关机构医疗保险普及工作的推进提供依据并对提升居民参保、续保积极性提出参考性建议。方法:根据实地情况制定调查问卷,采用随机抽样对眉山市仁寿县300名居民进行线上线下同步调研,对所得数据统计分析。结果:调研显示老年人医疗保险参保率较高(97.56%)。已参保人群中,六成多(64.17%)居民已缴费0~15年,六成(60%)居民年缴费200-500元,主要使用于住院报销(49.17%),主要以宣讲渠道了解(66.67%),对报销比例(38.33%)、便捷程度(50%)、服务态度(51.67%)的满意度均以一般为主。未参保人群中,未购买主要原因为节省开支(66.67%),期待年缴费价格以200~500元为主(66.67%),期待报销比例61%~90%、91%~100%各一半(50%)。结论:目前老年人对医保认知较少;保障效果城乡差异明显,普适性调整应加强;老年人的护理照料需求增加,护理保险制度具有补充医疗保险制度的发展潜能。提出建议,一、结合医疗保险知识展开宣传活动;二、考虑城乡经济发展差异影响因素制定方案,并引进先进基础医疗设施;三、针对老年人多方面医疗需求,扩大医保服务范围。多措并举以期巩固60岁以上人口医保普及成果并激发群众参保续保积极性。

Objective: To understand the current situation of the medical insurance penetration rate of people over 60 years old in Renshou County, Meishan City, analyze its influencing factors, provide a basis for the promotion of medical insurance popularization work by the government and related institutions, and provide reference suggestions for improving residents’ enthusiasm for insurance participation and renewal. Methods: A questionnaire was formulated according to the field conditions, and 300 residents in Renshou County, Meishan City were surveyed online and offline by random sampling, and the obtained data were statistically analyzed. Results: The survey showed that the medical insurance participation rate of the elderly was relatively high (97.56%). Among the insured population, more than 60% (64.17%) of the residents have paid for 0~15 years, and 60% (60%) of the residents have paid an annual fee of 200~500 yuan, which is mainly used for hospital reimbursement (49.17%), mainly through publicity channels (66.67%), and the satisfaction with reimbursement ratio (38.33%), convenience (50%), and service attitude (51.67%) is mainly general. Among the uninsured people, the main reason for not purchasing is to save expenses (66.67%), expect the annual payment price to be mainly 200~500 yuan (66.67%), and expect the reimbursement ratio to be 61%~90% and 91%~100% each half (50%). Conclusion: At present, the elderly have little awareness of medical insurance;the difference in the protection effect between urban and rural areas is obvious, and the universal adjustment should be strengthened;the nursing care needs of the elderly increase, and the nursing insurance system has the potential to supplement the development of the medical insurance system. Suggestions are made, first, to carry out publicity activities based on the knowledge of medical insurance;second, to formulate plans taking into account the influencing factors of urban and rural economic development differences, and to introduce advanced basic medical facilities;third, to expand the scope of medical insurance services for the various medical needs of the elderly. Multiple measures are taken to consolidate the achievements of the popularization of medical insurance for the population over 60 years old and stimulate the enthusiasm of the masses to participate in insurance renewal.