摘要
目的:探究医疗保险省级统筹、医疗服务质量对患者就医行为影响。方法:基于海南省县域医疗机构案例分析,选取海南省辖4个县/县级市的医疗机构作为研究对象。结果:海南省建立医疗保险省级统筹模式,以提升人民群众就医感受和医疗保障水平,降低患者异地就医门槛,消除医保报销差距。医疗服务质量对患者的就医决策起着重要作用,患者更倾向选择声誉较好的医疗机构和具备专业能力的医务人员。患者对医疗服务的过度追求可能导致医疗资源的浪费和不公平。结论:应积极推进分级诊疗政策的落实、提升基层医疗机构的服务能力、培养患者的医疗素养,以防止过度医疗发生。
Objective:To explore the impact of provincial-level pooling of medical insurance and healthcare service quality on patients’healthcare-seeking behavior.Methods:Based on a case study of county-level medical institutions in Hainan Province,medical institutions from four counties/county-level cities were selected for analysis.Results:Hainan Province has established a provincial-level pooling model for medical insurance to improve the healthcare experience and level of medical security for the public,reduce the barriers to crossregional medical treatment,and eliminate differences in insurance reimbursement.The quality of medical services plays an important role in patients’decision-making,with patients more inclined to choose reputable institutions and professional healthcare personnel.However,excessive pursuit of high-level services by patients may lead to resource waste and healthcare inequities.Conclusion:It is necessary to actively promote the implementation of the Hierarchical Medical System,enhance the service capacity of primary healthcare institutions,and cultivate patients’medical literacy to prevent over-treatment.
作者
周婧涵
邢林艳
王留明
汪洋帆
胡银环
ZHOU Jinghan;XING Linyan;WANG Liuming;WANG Yangfan;HU Yinhuan(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei Province,430030,PRC)
出处
《中国医院》
北大核心
2025年第6期22-26,共5页
Chinese Hospitals
基金
国家自然科学基金项目(72274068)。
关键词
医疗保险
省级统筹
医疗服务质量
就医行为
medical insurance
provincial-level pooling
healthcare service quality
healthcare-seeking behavior
