医疗保险对住院患者利用基层医疗服务的影响  

Study on the Influence of Medical Insurance on Utilize of Primary Medical Services of Inpatients

作　　者：朱小凤 陈晓芳[2] 汪瀚文 谭坤 ZHU Xiaofeng;CHEN Xiaofang;WANG Hanwen;TAN Kun(University of Electronic Science and Technology of China, Chengdu 611731, Sichuan, China)

机构地区：[1]电子科技大学数学科学学院,成都市611731 [2]四川省疾病预防控制中心,成都市610041 [3]遂宁市中心医院,遂宁市629000

出　　处：《中国卫生信息管理杂志》2019年第1期100-104,共5页Chinese Journal of Health Informatics and Management

基　　金：四川省卫生和计划生育委员会普及应用项目(项目编号:17PJ473);四川省基层卫生事业发展研究中心重点项目(项目编号:SWFZ17-Z-15)

摘　　要：目的了解住院患者对医疗保险的认知及利用情况,探讨医疗保险与理性就医之间的关系。方法采用多阶段分层抽样,对四川省6个地市州18家医疗机构的2 550名患者进行问卷调查,调查内容包括:患者的基本情况,对医疗保险的认知及利用情况,对基层医疗服务的利用情况等。结果最近一次住院治疗的患者医保报销比例为53.6%±26.7%。医疗保险类型不同,不同医疗机构之间报销比例差异越大,最近一次住院治疗的患者在患一般疾病时更倾向选择基层就诊。结论加大不同级别医疗机构之间的医保报销比例差异,制定科学合理的差异值,能够有效引导患者理性就医。Objective To know the cognition and utilize of medical insurance of patients, and investigate the relationship between medical insurance and rational medical treatment. Methods A multi-stage strati?ed sampling was conducted to survey 2550 patients in 18 different medical institutions in 6 cities in Sichuan province. The survey included the basic information of patients, awareness and utilize of medical insurance,and primary medical service.Results The rate of reimbursement for patient who were hospitalized recently was 53.6%±26.7%.The result showed that for different type of medical insurance, the greater reimbursement discrepancy between different medical institutions, the patients are more likely to choose primary medical institution for common diseases. Conclusions Enlarge the reimbursement discrepancy between medical institutions at different levels, and establish scienti?c and reasonable difference index,can effectively guide the patients to choose medical treatment rationally.

关 键 词：医疗保险 基层医疗服务 住院患者 

分 类 号：R-34[医药卫生] R197.1