影响农民参加新型农村合作医疗的因素研究

基于对江苏省宿迁市近年来实施的新型合作医疗制度运行情况的实地调查,深入分析了影响农民参加合作医疗意愿的因素,并提出了旨在维护参保农民切身利益、提高制度运行绩效、推动新型农村合作医疗制度可持续发展的政策建议。首先概述了样本的基本情况,然后运用层次分析法对各个因素予以筛选并对其重要性进行排序。结果显示,影响农民参加新型农村合作医疗制度的因素来自农民、政府和医院三方,其中最重要的是农民对自身身体状况的风险认知,同时政府针对新型农村合作医疗制度的政策立法、实施过程、风险监管以及定点医疗机构的服务价格、服务水平等也显著地影响农民参加新型合作医疗制度的意愿。为此,作为统筹解决农民全局问题的政府,必须协调农民自身、作为合作医疗管理机构的政府机构、定点医疗机构三者的关系,加快针对农民合作医疗问题的立法进程,加强取信于民的能力,加大对定点医疗机构的监督管理力度,推动我国农民医疗保障问题的解决。

Study on Influencing Factors of Farmers' Participating in New Rural Cooperation Medical Treatment

Field survey was carried out to study the operation situation of new rural cooperation medical system in Suqian city in recent years.Factors influencing the will of farmers' participating in the cooperative medical treatment were analyzed.Policy suggestions aiming to protect the benefit of farmers participating in the medical insurance,improve system operation performance,promote the sustainable development of new rural cooperation medical system.Basic situation of the sample was firstly introduced.Then each factor was screened by analytical hierarchy process(AHP) and their importance was ranked.Result showed that factors influencing farmers' participating in new rural cooperation medical system came from three aspects including farmer,government and hospital.Among them,the most important factor was farmers' cognizance on their own healthy condition.Meanwhile,policy legislation,management,surveillance level of government as well as the service price and service level of fixed-point medical institutions significantly affected the farmers' will of participating in new rural cooperation medical system.Therefore,government must coordinate the farmers,the fixed-point medical institutions and government agencies which acted as a cooperative medical management department.Government should speed up legislative process,strengthen the ability of earning trust from farmers,improve the supervision and management over fixed-point medical institutions and promote to resolve the problems of farmers' medical insurance.