摘要
目的:对我国城乡居民基本医疗保险的参保意愿及其影响因素进行系统评价和meta分析,为进一步优化调控政策提供基准证据.方法:系统检索CNKI、VIP、WanFang Data、Web of Science、PubMed和ScienceDirect数据库中有关我国城乡居民基本医疗保险参保意愿的相关研究.用美国卫生保健质量和研究机构推荐的 11 条标准评价文献质量,用Stata 16.0 进行meta分析.结果:共纳入 37 项横断面研究,包括63601 例调查对象.我国城乡居民基本医疗保险参保意愿率为 71.5%[95%CI(65.9%,77.2%)].2016 年后的调查(80.5%)、中西部地区(79.6%)、60 岁以上(65.7%)、农村居民(74.1%)参保意愿较高;居民的参保意愿与自评健康状况存在负相关,与医保制度满意程度呈正相关.结论:我国城乡居民基本医疗保险总体参保意愿率较高,但仍有地区、年龄、居民健康状况等因素影响着居民的参保意愿,对此,相关部门需精准识别影响居民参保意愿的因素,为制定可持续发展的医保制度提供支持.
Abstract
Objective:Systematically evaluate the participation willingness and influencing factors of Chinese urban and rural residents'basic medical insurance,and to provide higher-level reference evidence for further optimizing and adjusting policies.Methods:Systematically searched CNKI,VIP,WanFang Data,Web of Science,PubMed and ScienceDirect databases for relevant studies on participation intention of basic medical insurance of urban and rural residents in China.Literature quality was evaluated using 11 criteria recommended by the Institute for Health Care Quality and Research(AHRQ),and Stata16.0 software was used for analysis.Results:Included in 37 cross-sectional studies,including 62441 subjects.The results of meta-analysis showed that the willingness rate of urban and rural residents to participate in basic medical insurance was 71.5%[95%CI(65.9%,77.2%)].The study after 2016(80.5%),the central and western regions(79.6%),over 60 years old(65.7%),and rural residents(74.1%)had a higher intention to participate in insurance.There is a negative correlation between residents'willingness to participate in in-surance and self-assessed health status,and a positive correlation with system satisfaction.Conclusion:The overall participation intention rate of basic medical insurance for urban and rural residents in China is relatively high,but there are still factors such as region,age,and health status of residents that affect residents'willingness to participate in insurance.In this regard,relevant de-partments need to accurately identify the factors that affect residents'willingness to participate in insurance and provide support for the development of a sustainable medical insurance system.
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