基本医疗保险经办服务满意度及优化路径研究——基于镇江、东莞、成都、神木、银川的实证分析  

Satisfaction Degree of and Optimization Path for Basic Medical Insurance Administrative Service——An Empirical Analysis Based on Zhenjiang,Dongguan,Chengdu,Shenmu and Yinchuan

作　　者：翟绍果[1] 徐顺锋[1] 郭锦龙[1] 

机构地区：[1]西北大学公共管理学院,陕西西安710127

出　　处：《保险研究》2013年第10期87-93,共7页Insurance Studies

基　　金：国家社科基金青年项目"基于国民均等受益的健康保障路径研究"(11CGL070)

摘　　要：经办服务关系着基本医疗保险的可及性,城乡居民对于基本医疗保险经办服务的满意程度是衡量全民医保实施效果的重要指标。本文基于基本医疗保险经办问题的部门之争和学界讨论.通过对镇江、东莞、成都、神木、银川五地城乡居民医保经办服务满意度的调查,采用描述性分析、交互分析、二元Logistic回归分析,研究发现我国医保经办服务存在着整体满意度较低、医保经办管理主体混乱、各地经办服务水平参差不齐等问题。因此,优化我国医保经办服务的路径在于,整合医保经办机构,引入商业保险公司参与医保经办服务,建立医保经办机构同医疗服务方谈判机制,落买医保关系的转移接续,加强医保系统信息化建设,优化医疗服务水平。The quality of administrative servicesi mpacts the accessibility of basic medical insurance, and the urban and rural residents＇ satisfaction on the services is an important indicator for measuring the implementation effects of basic medical insurance. Based on existing disputes among various departments and academic discussions on the basic medical insurance administrative services, and through satisfaction surveys on urban and rural residents in Zhenjiang, Dongguan, Chengdu, Shenmu and Yinehuan, the paper used descriptive analysis, interaction analysis and binary Logistic Regression analysis to revealed that there existing the following problems： low level of overall satis- faction, chaotic management bodies, and uneven service levels, etc. Therefore, the path for optimizing medical insur- ance services was to consolidate medical insurance administration agencies, introduce commercial insurance compa- nies as service providers, establish the negotiating mechanism between medical care providers and service adminis- trators, realize the transfer and continuation of the relationship between medical insurance systems, enhance informa- tion technology, and improve on medical services.

关 键 词：经办服务 满意度 优化路径 

分 类 号：F840.61[经济管理—保险]