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目的:分析影响医保制度整合必要性的因素。方法:采用方便抽样法进行问卷调查,采用χ2检验、二元logistic回归进行数据分析。结果:影响医保制度整合必要程度的因素为现行医保制度通过完善能实现全民医保目标(OR=0.467)、整合使医保基金的风险分担能力更强(OR=2.320),整合改变制度的多头管理状况、降低成本、提高管理效率(OR=2.122),整合减少重保或漏保现象、实现资源利用最大化(OR=1.952),已经开展的整合试点没有实质性改善原有制度之间的不公平(OR=0.380)。结论:急需建立医保制度整合改革的综合评价指标体系和评价工具,以进一步指导和推动医保整合改革。
Objective: To analyze the factors that affect the necessity of integration of medical insurance system. Methods: Convenient sampling method was used to conduct questionnaire survey, using χ2 test and binary logistic regression analysis. Results: The factors influencing the degree of integration of the medical insurance system are that the current health insurance system can achieve the goal of universal health insurance (OR = 0.467) through perfection, and the consolidation makes the risk sharing ability of the medical insurance fund stronger (OR = 2.320) (OR = 2.122), reduce the reinsurance or leakage and reduce the costs, improve the management efficiency (OR = 2.122), consolidate the reduction of reinsurance or leakage protection, and maximize the utilization of resources (OR = 1.952). The integration pilot projects conducted have not substantially improved the unfairness of the original system (OR = 0.380). Conclusion: It is urgent to establish a comprehensive evaluation index system and evaluation tool for the integrated reform of the medical insurance system to further guide and promote the integration reform of medical insurance.