刘彩



医疗保险对农村成人乙肝疫苗接种意愿的影响分析

刘彩

【摘要】目的探讨农民医疗保险对其乙肝疫苗接种意愿的影响。方法问卷调查河北省12个村的4 020名成人，重点分析其中未接种过乙肝疫苗的2 315名调查对象的接种意愿，以医疗保险为关键变量拟合Logistic回归模型。结果2 315名调查对象中，有接种意愿者923人(39.9%)。不同医保分组人群的乙肝疫苗接种意愿差异具有统计学意义(χ2=7.795，P=0.020)。Logistic回归分析结果显示，在控制性别、年龄、婚姻状况、受教育程度、收入、知识得分、距离接种机构的路程时间和自评健康条件下，医疗保险会影响乙肝疫苗接种意愿，具体来说，城镇职工医疗保险及城镇居民医疗保险参保者和在新农合基础上又购买了商业健康保险者，在将来选择接种乙肝疫苗的概率是无医保者的2.577倍(1/0.388)，是新农合参保者的2.278倍(1/0.439)。同时，具有统计学意义的影响因素还有年龄、受教育程度和知识得分3个变量。结论将乙肝疫苗费用纳入医疗保险支付有利于防控乙肝，并符合医疗保险发展趋势。

【关键词】医疗保险；新型农村合作医疗；乙肝疫苗；意愿

Study on Influence of Medical Insuranceon Willingness of Injecting Hepatitis B Vaccine among Rural Adults

LIU Cai.ManagementSchool,TianjinUniversityofChineseTraditionalMedicine,Tianjin, 300073,China

【Abstract】ObjectivesTo explore the influence of medical insurance on willingness of injecting Hepatitis B vaccine among rural adults. Methods4 020 adults from 12 villages in Hebei province were investigated by using questionnaire. The willingness of injecting Hepatitis B vaccine of 2 315 respondents who have not vaccinated was focused on, and Logistic model was employed to analyze the data with medical insurance as a key variable. ResultsThe willingness of injecting Hepatitis B vaccine among rural adults was influenced by medical insurance (χ2=7.795,P=0.020), and there were 923 out of 2 315 (39.9%) respondents who were willing to inject. Logistic regression results showed that medical insurance did influence willingness of injecting under the condition of controlling gender, age, marital status, education level, income, knowledge score, time to injection institution and self-evaluated health status. Specifically, the probability of injecting hepatitis B vaccine among those who covered by medical insurance for urban workers and medical insurance for urban residents and those who covered by both new rural cooperative medical scheme and commercial health insurance was as 2.577 (1/0.388)times as those who have no medical insurance, and as 2.278(1/0.439)times as those who covered only by new rural cooperative medical scheme. Meanwhile, age, education level and knowledge score were also statistically significant variables. Conclusions Integrating payment of Hepatitis B vaccination into medical insurance is benefit for the prevention and control of Hepatitis B, and which is the development tendency of medical insurance.

【Key words】 Medical insurance;New rural cooperative medical scheme;Hepatitis B vaccine;Willingness

我国预防接种服务筹资渠道较为单一，I类疫苗依靠政府财政支持，Ⅱ类疫苗主要依靠使用者付费[1]。我国的医疗保险发展尚处于单一的“疾病保险”阶段，WHO在2005年提出社会健康保险制度的定义为 “人人在一个可支付得起的水平上，获得主要的健康促进、预防、治疗和康复的卫生干预措施”，而逐步向健康保险过渡将成为必然趋势。……