居民医保安全感测量量表的开发与信效度检验  

Study on the Development,Reliability and Validity of a Scale to Measure Residents′Sense of Security in Health Insurance

作　　者：康正 许金鹏 孔歆淼 石淇 刘剑 何靖冉 邓芳敏 陈方厅 张洪宇 张婷 吴群红 田国梅[3] Kang Zheng(School of Health Management,Harbin Medical University,Harbin,P.R.China)

机构地区：[1]哈尔滨医科大学卫生管理学院社会医学教研室,黑龙江哈尔滨150081 [2]哈尔滨医科大学公共卫生学院 [3]哈尔滨医科大学附属第四医院核医学科

出　　处：《中国卫生事业管理》2023年第8期597-600,621,共5页Chinese Health Service Management

基　　金：国家自然科学基金面上项目“复杂监管网络空间视域下的医疗保障基金监管协同治理机制研究”(72074064);国家社会科学基金重点项目“国家医疗保障基金监管手段与创新模式研究”(19AZD013)。

摘　　要：目的:编制居民医保安全感测量量表,为测量医疗保障制度给居民带来的安全感水平提供方法与工具。方法:采用文献研究法、专题小组讨论法、专家访谈法构建量表框架、维度及条目;采用探索性因子分析、Cronbach’sα系数和验证性因子分析法对量表的信度和效度进行检验。结果:居民医保安全感量表由确定控制感、心理归属感、卫生服务可及感、经济承受感、社会支持感和信任与信心6个维度共26个条目组成,累计贡献率为73.042%。总量表的Cronbach’sα系数为0.927,分半信度为0.797;χ^(2)/DF=1.314,RMR=0.058,RMSEAH=0.043,模型拟合良好。结论:研究开发的居民医保安全感测量量表具有良好的信度和效度,能够有效地测量医疗保障制度带给居民的安全感水平。医疗保障制度赋予居民安全感排前三位要素的是居民经济承受感、信任与信心、确定控制感。Objective To develop a scale for measuring residents′sense of security in health insurance,and provide a method and tool for measuring the level of sense of security of residents brought by the health care system.Methods The framework,dimen⁃sions and entries of the scale were constructed using literature research,focus group discussion and expert interview methods.The reliability and validity of the scales were tested using exploratory factor analysis,Cronbach′s alpha coefficient and confirmatory fac⁃tor analysis,respectively.Results The scale consists of 26 entries on 6 dimensions,which are determining a sense of control,psy⁃chological belonging,accessibility to health services,affordability,social support and trust and confidence,with a cumulative contri⁃bution rate of 73.042%.The reliability and validity of the scale were satisfactory.Conclusion The developed scale has good relia⁃bility and validity,which can effectively measure the level of sense of security brought to the residents by the health care insurance system.The top three elements of sense of security provided by the health care system were a sense of affordability,trust and confi⁃dence,and a sense of certainty and control.

关 键 词：安全感 参保居民 量表开发 信度 效度 

分 类 号：R197.1[医药卫生—卫生事业管理]