大学生基本医疗保险的满意度体系构建与评估

Construction and Evaluation of the Satisfaction System of Basic Medical Insurance for College Students

摘要: 大学生参与基本医疗保险是实现“全民医保”的重要一步。然而，大学生基本医疗保险逐渐难以满足当代大学生的基本需求，导致了大学生对“大学生医保”的满意度下降。本文建立起经办服务感知、医保政策感知、医疗服务感知、药械感知4个维度、16个指标的满意度体系，并运用层次分析法和德尔菲法对大学生基本医疗保险的满意度体系进行权重设计。通过在上海市松江大学城开展调查和统计，并根据得分和权重进行重要性–表现程度分析，建议：政校互通，保障医疗保险体系覆盖大学生；报销增加，保障大学生就医的报销范围；加强监管，保障医保经办人员和医护人员效率提升；商保补充，覆盖基本医疗保险范围之外的空白。

Abstract: The participation of university students in basic medical insurance is an important step towards the realization of “universal medical insurance”. However, the basic medical insurance for university students has gradually failed to meet the basic needs of contemporary university students, which has led to a decline in the satisfaction of university students with the “university medical insurance”. This paper establishes a satisfaction system with 4 dimensions and 16 indicators, namely, perception of management services, perception of health insurance policies, perception of medical services, and perception of medicines and equipment, and uses hierarchical analysis and the Delphi method to design the weights of the satisfaction system of college students’ basic health insurance. By conducting surveys and statistics in Songjiang University City, Shanghai, and analyzing the importance-performance degree according to the assigned scores and weights, it is suggested that: government and university interoperability to guarantee that the medical insurance system covers college students; increased reimbursement to guarantee the reimbursement scope of college students’ medical treatment; strengthened supervision to guarantee the efficiency of medical insurance operators and healthcare personnel; and commercial insurance supplementation to cover gaps outside the scope of basic medical insurance.