武汉市城镇职工医疗保险门诊共济政策感知价值水平、影响因素与生成机制研究  

A study on the level,influencing factors and generating mechanisms on the perceived value of covering outpatient medical bills under the basic medical insurance for urban employees in Wuhan city

作　　者：张心蕊 姚强[2,3] ZHANG Xinrui;YAO Qiang

机构地区：[1]中国人民大学人口与健康学院,北京100872 [2]武汉大学政治与公共管理学院,湖北武汉430072 [3]武汉大学社会保障研究中心,湖北武汉430072

出　　处：《社会保障研究》2024年第4期81-99,共19页Social Security Studies

基　　金：国家自然科学基金面上项目“激励相容视角下农村居民慢性病经济风险协同治理机制研究”(72174149);武汉大学自主科研项目(人文社会科学)数智文科牵引专项“数智驱动的健康贫困治理研究”(413000171);2023年武汉大学本科教育质量建设综合改革项目(一流本科专业建设项目)的阶段性成果。

摘　　要：探究武汉市职工医保门诊共济政策感知价值对于了解人民群众需求和完善政策具有重要意义。基于公共价值管理理论与感知价值理论,利用线性回归、Shapley分解和Sobel中介效应检验,分析参保人门诊共济政策感知价值的水平、影响因素及生成机制,结果显示:武汉市职工医保门诊共济政策感知价值水平较低;政策感知价值存在人群异质性,中老年、受教育程度低、已退休、月收入高的参保人政策感知价值更低;政策了解程度、就医方便程度、就医购药花费是政策感知价值的重要预测变量,就医方便程度、购药方便程度通过政策了解程度间接影响政策感知价值。建议科学设置待遇保障水平,缩小改革前后的获益差距;重视公共价值形成中公众的作用,加强重点人群价值传递;加强医疗机构与零售药店的优势互补,提升医疗服务可及性。Exploring the perceived value of the covering outpatient medical bills under the basic medical insurance for urban employees in Wuhan City is significant for understanding the needs of the people and improving the policy.Based on the theory of public value management and the theory of perceived value,linear regression,Shapley regression,and Sobel mediation effect tests,this paper analyzes the level,influencing factors and formation mechanisms of the perceived value of the covering outpatient medical bills under the basic medical insurance for urban employees.The results show that the level of perceived value of the covering outpatient medical bills policy is low.There is population heterogeneity in the perceived value of the policy,and the level of perceived value is lower among the participants with middle age or old age,low education level,retirement status and high monthly incomes.The degree of policy understanding,the degree of convenience of medical treatment,the cost of medical treatment and drug purchasing are the important predictor variables of the perceived value.The degree of convenience of medical treatment and drug purchasing indirectly affects the perceived value through the policy.Based on this,this paper puts forward the following suggestions.Firstly,set the level of protection level scientifically and narrow the gap between the benefits before the reform and he benefits after the reform.Secondly,pay attention to the role of the public in the formation of public value,and to strengthen the value transmission of the key groups.Thirdly,strengthen the complementary advantages between medical institutions and retail pharmacies,and enhance the accessibility of medical services.

关 键 词：职工医保 门诊共济 公共价值 感知价值 

分 类 号：F842.684[经济管理—保险] R197.1[医药卫生—卫生事业管理]