【作者】 杜娟；

【导师】 汪凯；

【作者基本信息】 四川大学 ， 社会医学与卫生事业管理， 2006， 硕士

【摘要】 目的：分析四川省基本医疗保险利用基层卫生服务的现状以及基本医疗保险制度下人群择医行为及其影响因素，发现存在的问题，为促进基本医疗保险制度利用基层卫生服务提供政策建议。 方法：收集整理四川省基本医疗保险运行五年数据，分析基本医疗保险运行情况以及利用基层卫生服务的情况；通过文献查阅法采集四川省基本医疗保险与社区卫生服务相关政策；采用分层抽样选取成都市不同级别医院的门诊和住院病人进行择医行为的调查。 结果：1 基本医疗保险老龄化程度加剧，基本医疗保险基金支出增加。2 基本医疗保险对基层卫生服务的利用不足，参保人员主要前往二、三级医院就医。3 基本医疗保险高成本运行，基金大部分流向二、三级医院，医疗保险基金面临失衡的危险。4 总体上讲，四川省基本医疗保险政策对社区卫生服务支持不足。5 各级医院各具特色吸引病人。医疗技术水平高、医疗设备好是上级医院吸引病人就医的主要原因，价格便宜、候诊时间短是基层医院的优势。 结论：人口老龄化和高成本运行给四川省基本医疗保险的发展带来压力，积极引导参保人员利用基层医疗服务能有效解决问题。加强基本医疗保险对基层卫生服务的政策支持是解决利用不足的关键。基层医疗机构要量身打造经营战略吸引患者前往就医。更多还原

【Abstract】 Objectives: Through analyzing status of basic medical insurance utilizing primary health service in Sichuan province from 2001 to 2005, and investigating patients’ behavior of choosing hospitals and associated factors, to find out problems and provide policy suggestion for promoting basic medical insurance to utilize primary health service.Methods: To collect the data for 5 years of basic medical insurance in Sichuan province, and analyze the situation of operation of basic medical insurance and judge whether basic medical insurance utilized primary health service sufficiently; To review basic medical insurance policies related community health service; Through stratified sampling to investigate patients’ (including outpatients and inpatients) behaviors of choosing hospitals in 15 hospitals at different levels in Chengdu with the questionnaires.Results: 1 For the aging was more severe, the expenditure of basic medical insurance fund increased. 2 Basic medical insurance didn’t utilize primary health service sufficiently. The individuals participating basic medical insurance mostly chose hospitals at secondary or tertiary levels. 3 Expenditure of basic medical insurance was mainly distributed in hospitals at secondary or tertiary levels, which resulted that the cost of operation of basic medical insurance was high and the fund would be unbalanced. 4 Basic medical insurance polices in Sichuan province didn’t promote the progress of CHS facilities efficiently. 5 Hospitals at different levels owned various advantages to attract patients. High medical technology and excellent medical更多还原