A Comparative Study On The Satisfaction Of Medical Insurance For Urban And Rural Residents In Xinjiang

Objective:We analyze the satisfaction of urban and rural residents in Xinjiang autonomous region of the Urban Residents Basic Medical Insurance Institution and the New Rural Cooperative Medical to clear the differences both of them and find the reason,and provide reference for the integration of urban and rural medical insurance system in Xinjiang autonomous region.Methods:Multi-stage random sampling method was used to investigate the population in urban and rural areas of Xinjiang.The differences of satisfaction of medical insurances are analyzed from cognition,designated medical institutions,compensation mechanism and agencies,and the influencing factors of urban and rural health care satisfaction are analyzed by using multiple linear regression analysis.Results:In the satisfaction of urban and rural medical insurances,grassroots hospitals are the primary medical institution for urban and rural residents such as grassroots village clinics,township hospitals and community hospitals;The satisfaction of medical insurance is different in the importance of family(χ2=27.122,p<0.001)and farmer’s satisfaction is high;There is a statistically significant difference between the insured urban and rural residents awareness of the health care system of the type of compensation,compensation scope,compensation standard,compensation deductible,and the proportion of Reimbursement Program(p<0.05),urban awareness is low;The regional health resources planning is not reasonable,grassroots medical institutions’ satisfaction of treatment level,environment and equipment level are lower;The convenience of treatment at all levels of the designated medical institutions is poor,especially in urban;in addition to hospitals,medical staff Service satisfaction is low at all levels of medical institutions,especially in urban;Residents are of the view that the level of individual contributions is high and different(χ2=9.554,p=0.049),especially in urban;Deductible and reimbursement of hospitalization rationality is not high,especially in prefecture hospital and autonomy hospital was reasonable of higher deductibles and lower reimbursement ratio,especially in urban(p<0.05);There’s different of satisfaction in Medicare reimbursement drug list range(t=4.310,p<0.001),treatment project(t=5.343,p<0.001)and service facilities project(t=5.091,p<0.001),and rural is higher;Both residents are of the view that the reimbursement procedures is cumbersome,and "requested data is too much","not reimbursed immediately" and "not reimbursed timely" are the main problem encountered in the reimbursement process.In terms of the factors affecting the satisfaction degree of urban and rural medical insurance,the policy standards and agencies are the main factors that affect the overall satisfaction of urban and rural residents,especially in three factors about the importance to the family,reimbursement procedures and personal payment level.In addition,the medical health insurance treatment project and service facilities project are the important factors affecting urban and rural health care satisfaction.Conclusion:We should advance the cognitive level of medical insurance by improving propaganda,and make the regional health resources planning to promote quality resources to sink,improve the medical convenience by perfect hospital information construction and make the treatment process simple,build the mechanism of examine of technical training and strengthen the service attitude of medical staff,improve the rationality of compensation mechanism,the level of individual payment should be distinguish,and the insurance directory should be expensed,at the same time,deductible and reimbursement rate should be reasonable in prefecture hospital and autonomy hospital,make the medical insurance management department unified and integrate mechanism of handle agency to improve its service ability and simplify reimbursement process,increase financing channels and enhance financing capacity.