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目的了解湖南省城镇职工基本医疗保险参保住院患者的支付意愿现状及主要影响因素,为城镇职工医保的持续发展提供可行性建议。方法采用分层随机抽样的方法,在湖南省医疗工伤生育保险管理服务局信息系统中抽取长沙市1 025名2013年有住院记录的城镇职工医保参保患者,应用条件价值评估法进行支付意愿的现况调查,并分析支付意愿的主要影响因素。结果城镇职工医保参保患者中,92.7%的人表示若可以选择仍愿意购买湖南省城镇职工医保,支付意愿的中位数为60.00元,占职工月平均工资的1.8%;岭回归分析显示,参保住院患者的年龄(β=-0.044)、家庭人均月收入(β=0.190)、文化程度(β=0.040)、自评健康状况(β=-0.056)是其支付意愿的主要影响因素。结论住院参保职工的支付意愿不强,建议加大对弱势群体的经济补贴,完善现行城镇职工补充医疗保险制度,建立多层次的医疗保障体系。
Objective To understand the status quo of the willingness to pay and the main influencing factors of inpatients participating in basic medical insurance for urban workers in Hunan Province and to provide feasible suggestions for the sustainable development of urban workers’ health insurance. Methods A stratified random sampling method was used to select 1 025 urban employees’ medical insurance insured patients who had hospitalized records in 2013 in Changsha Information System of Medical Injury and Childbirth Insurance Management and Service Bureau and paid the willingness to pay Survey the status quo and analyze the main factors that affect the willingness to pay. Results Among urban employees, 92.7% said they would still be willing to buy the urban employees in Hunan Province if they had the option to buy medical insurance. The median willingness to pay was 60.00 yuan, accounting for 1.8% of the monthly average salary of workers. According to the ridge regression analysis, The main factors influencing the willingness to pay were the age (β = -0.044), monthly per capita income (β = 0.190), educational level (β = 0.040) and self-rated health status (β = -0.056) Conclusions The willingness to pay for inpatient insured workers is not strong. It is suggested to increase the economic subsidies for vulnerable groups, improve the current medical insurance system for urban workers and establish a multi-level medical insurance system.