江夏区城乡医保整合后试点居民参保意愿及影响因素分析

目的了解武汉市江夏区城乡医保整合后试点居民参保意愿的真实情况及主要影响因素,为武汉市完善城乡医保整合政策提供依据。方法于2018年6月,运用分层随机抽样方法,抽取武汉市江夏区3个街道和6个乡镇的城乡居民共356人进行问卷调查,对可能影响居民参保意愿的因素进行单因素χ^2分析和多因素Logistic回归分析。结果共调查356人,其中258人(72.47%)表示仍愿意参加城乡医保,98人(27.53%)表示不愿意继续参加;对当前制度表示满意的有317人(89.04%),不满意的有39人(10.96%);对当前制度了解的有230人(64.61%),表示不了解的有126人(35.39%);Logistic回归分析结果显示,农村居民(OR=0.484)、对医保报销后费用负担评价较认可(OR=2.009)和报销便捷度较方便(OR=2.379)是影响城乡居民参保意愿的主要因素(P<0.05)。结论江夏区城乡医保整合后居民参保意愿较高,但医保制度的设计需关注居民医保费用负担与医保报销状况,并加强宣传力度,提高城乡居民对医保整合的认知。

Willingness-to-participate in Medical Insurance and Its Influencing Factors among Residents in Jiangxia Distric after Integration of Urban and Rural Medical Insurance Systems

Objective To investigate the willingness-to-participate in medication insurance and its influencing factors among urban and rural residents in Jiangxia district of Wuhan city,and provide the basic theory for improving the urban and rural medical insurance integration policy in Wuhan.Methods Stratified random sampling was used to recruit 356 residents from 3 streets and 6 townships in Jiangxi district for a household face-to-face questionnaire survey on willingness and relevant factors for participating in medical insurance during June 2018.Chi-square test and logistic regression model were applied in data analyses.Results Of the 356 residents surveyed,72.47%reported the willingness to participate in urban and rural medical insurance system and 27.53%did not report the willingness.89.04%expressed their satisfaction about current medical insurance system while 10.96%were not satisfied with the system.35.39%did not present the understanding the current medical insurance system and 64.61%showed the understanding to the system.The results of multivariate logistic regression revealed that rural resident(OR=0.484),more recognized the cost burden after medical insurance reimbursement(OR=2.009)and more convenient for reimbursement(OR=2.379)were the main factors affecting the willingness to participate in the insurance(P<0.05).Conclusion After the integration of urban and rural medical insurance in Wuhan,the residents'willingness to participate in insurance is higher.However,the design of the medical insurance system should pay attention to the burden of medical insurance and the reimbursement of medical insurance,and strengthen publicity to raise the awareness of urban and rural residents on the integration of medical insurance.