中等城市卫生服务需方对现行医疗保险制度的反应性研究

目的明确卫生服务需方对城镇职工医保的评价,分析目前实施过程中存在的问题及原因,提出改进策略,为完善城镇职工医疗保险制度提供参考.方法运用多种社会学调查方法对某中等城市卫生服务需方进行现场调查,包括专题小组讨论、个别访谈、现场观察等.结果需方对城镇职工医疗保险改革最关注的问题是:能否参与医保,在其就医时能否得到经济的支持;医疗服务的提供问题,其中医疗费用过高、医疗服务提供的不合理、医德等问题较为突出;医保管理制度的便民性有待加强.结论实行医保广覆盖,设立不同层次的医疗保险以满足不同层次的需要;解决医保的医疗费用过高的问题;争取社区卫生服务成为医保的定点机构,提高服务质量、扩大服务范围;对一些新的职业性疾病提供优惠政策.

The Study of Health Service Demanders to Urban Workers Basic Medical Insurance

Objective Understand judgment and suggestion of health service demanders to medical insurance reform, find out existing problem,insufficient and its reasons,offer reference information and theoretical foundation to standardize urban workers medical insurance reform,satisfy the basic health service demand of the masses of crowds, perfect the policy and tactics of health reform.Methods The materials stemmed from on-the-spot investigation of health service demanders in some medium-sized city in October of 2003,the main quality investigation methods include:pane discussion,individual interview,on-the-spot investigation and so on.Results The demanders pay close attention to urban workers medical insurance reform,such as:Whether they can participate in the medical insurance,whether can get economic support;Offering questions of medical service,hospitalization cost too high,medical service supplement unreasonable,medical ethics,etc;The operation policy of the medical insurance does not perfect and not convenient. Conclusion Expand the coverage rate of the medical insurance,set up the different levels of insurance to satisfy different levels demand;Solve the problem of hospitalization cost too high;Wish community's health service as the issue of medical insurance,improve service quality,expand service range;Supply benefit policy to some new occupational disease,make then enjoy more medical service.