广州市灵活就业人员参加职工基本医疗保险行为的影响因素研究  

Research on the Influencing Factors of Flexible Employees'Participation in the Basic Medical Insurance for Employees in Guangzhou

作　　者：李梦颖 伍琳[1] 熊抚辰 陈永法[1] LI Mengying(School of International Pharmaceutical Business,China Pharmaceutical University,Nanjing,Jiangsu,211198,China)

机构地区：[1]中国药科大学国际医药商学院,江苏南京211198

出　　处：《医学与社会》2025年第1期70-78,共9页Medicine and Society

基　　金：国家社会科学基金资助重大项目,编号为15ZDB167;国家社会科学基金资助项目,编号为15BZZ052;2024年国家级大学生创新创业训练计划项目,编号为202410316043Z。

摘　　要：目的:探究广州市灵活就业人员参加职工基本医疗保险行为的影响因素,为提高灵活就业人员职工基本医疗保险参保率提供参考。方法:于2023年10月,采用分层随机抽样法对广州市灵活就业人员进行问卷调查,采用结构方程模型分析参保态度、主观规范、知觉行为控制、参保认知情况等变量对参保意愿与参保行为的影响路径,运用Bootstrap法分析参保意愿的中介效应。结果:灵活就业人员的参保态度(β=0.27,P<0.001)、主观规范(β=0.34,P<0.001)因素直接影响其参保意愿,并通过参保意愿的中介效应对参保行为产生影响;灵活就业人员参保意愿(β=0.314,P<0.001)、知觉行为控制(β=0.168,P<0.05)因素对参保行为的正向作用均显著;参保认知情况(β=0.233,P<0.01;β=0.211,P<0.001)既直接对参保行为产生积极影响,也对参保意愿产生积极影响。结论:灵活就业人员参加职工基本医疗保险的行为受参保意愿、知觉行为控制、参保认知情况直接影响,受参保态度、主观规范间接影响。建议探索建立筹资分担机制、拓宽参保途径、加大宣传与教育力度等措施,提高灵活就业人员职工基本医疗保险参保率。Objective:To explore the behavioral influences in flexible employees'participation in basic medical insurance for employees in Guangzhou,so as to provide reference for improving the participation rate.Methods:In October 2023,a questionnaire survey was conducted among flexible employees in Guangzhou through stratified random sampling method,the paths of the influence of variables such as insurance attitude(IA),subjective norms(SN),perceived behavioral control(PBC),insurance cognition(IC)on insurance intentions(II)and insurance behavior(IB)were examined using structural equation modeling,and the mediating effect of II was examined using the Bootstrap method.Results:Flexible employees'IA(β=0.27,P<0.001)and SN(β=0.34,P<0.001)positively affect II,and have effects on IB through the mediating effect of II.The positive effects of II(β=0.314,P<0.001)and PBC(β=0.168,P<0.05)on IB are significant.IC(β=0.233,P<0.01;β=0.211,P<0.001)has a positive effect both directly on IB and II.Conclusion:The IB of flexible employees is directly affected by II,PBC,IC,and indirectly affected by IA and SN.It is suggested that exploring the establishment of a financing sharing mechanism,broadening participation paths,increasing publicity and education,in order to increase the participation rate of flexible employees in the basic medical insurance for employees.

关 键 词：职工基本医疗保险 灵活就业人员 广州 

分 类 号：R-05[医药卫生] R197.1