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中文题名:

 珠海市“大爱无疆”补充医疗保险满意度评价研究    

姓名:

 吴思越    

保密级别:

 公开    

论文语种:

 中文    

学科代码:

 125200    

学科专业:

 公共管理    

学生类型:

 硕士    

学位:

 公共管理硕士    

学位类型:

 专业学位    

学位年度:

 2023    

校区:

 珠海校区培养    

学院:

 政府管理学院    

第一导师姓名:

 檀秀侠    

第一导师单位:

 北京师范大学政府管理学院    

提交日期:

 2022-12-24    

答辩日期:

 2022-12-17    

外文题名:

 RESEARCH ON SASTISFACTION EVALUATION OF ZHUHAI SUPPLEMENTARY HEALTH INSURANCE “DAAIWUJIANG”    

中文关键词:

 补充医疗保险 ; “大爱无疆” ; 满意度评价 ; 主成分分析 ; 回归分析 ; 四象限图    

外文关键词:

 Supplementary health insurance ; "Daaiwujiang" ; Satisfaction evaluation ; Principal component analysis ; Regression analysis ; Four-matrix chart    

中文摘要:

1993年首次提出建立职工医疗保险制度以来,经过将近20年的发展,珠海市医疗保险体系在探索中逐渐走向实际,在改革中逐渐走向稳定,在发展中逐渐走向完善。目前,珠海市医疗保险已经形成了基本医疗保险+补充医疗保险+附加补充医疗保险的多重层次、多重保障体系,为珠海市民以及非珠海户籍的常住人口提供了全覆盖高水平的医疗保障制度。在构建多层次医疗保障体系阶段,珠海市于2019年施行了珠海市“大爱无疆”补充医疗保险。在珠海市“大爱无疆”补充医疗保险产品发行三年以来,累计参保人数264.07万人,平均年参保人数88.01万人,累计赔付总支出13.10亿元,累计支付待遇人次33677人,人次均待遇支付3.89万元。

本文以珠海市补充医疗保险“大爱无疆”满意度为研究目标,依据顾客满意度评价模型设置了参保人预期、参保人感知质量、参保人感知价值、参保人满意度、参保人抱怨以及参保人信任6个一级指标,以及相关联的20个二级指标,采用了问卷形式对珠海市香洲区、金湾区、斗门区、高新区等地区的参保人进行了调查。首先,本文采用了主成分分析法构建了珠海市补充医疗保险产品“大爱无疆”满意度综合评价指标。然后,本文将参保人感知质量和感知价值这两个主要影响因素对参保人满意度综合评价指标进行了回归分析,发现“大爱无疆”的保费金额、保障范围、保障水平、咨询服务、理赔手续、窗口工作人员专业性和减轻医疗费用经济负担对满意度综合评价指标有着显著的正向影响,理赔手续以及缴费标准对满意度综合评价指标有着显著的负向影响,最后,本文采用四象限图对满意度的影响因素进行了象限定位,并据此提出相应的建议。

外文摘要:

Since the establishment of the employee health insurance system was first proposed in 1993, after nearly 20 years of development, Zhuhai's health insurance system has gradually become practical in exploration, stable in reform and perfect in development. At present, Zhuhai health insurance has formed a multi-level and multiple security system of basic health insurance + supplementary health insurance + additional supplementary health insurance, providing a full coverage and high-level health security system for Zhuhai citizens and non-permanent residents. In the stage of building a multi-level health security system, Zhuhai implemented the Zhuhai “Daaiwujiang” supplementary health insurance in 2019. Since the issuance of the supplementary health insurance product of “Daaiwujiang” in Zhuhai three years ago, the accumulative number of insured people has reached 2.6407 million, the average annual number of insured people has reached 880100, the accumulative total compensation expenditure has reached 1.310 billion yuan, the accumulative number of paid benefits has reached 33677, and the per person average benefits have been paid 38900 yuan.

Taking the satisfaction of Zhuhai supplementary medical insurance as the research objective, this paper sets six first level indicators, including the insured's expectation, the insured's perceived quality, the insured's perceived value, the insured's satisfaction, the insured's complaint and the insured's trust, as well as 20 related second level indicators, according to the customer satisfaction evaluation model. This paper investigates the insured in Xiangzhou District, Jinwan District, Doumen District, Gaoxin District and other areas of Zhuhai City by questionnaire. First of all, this paper uses the principal component analysis method to build a comprehensive evaluation index of satisfaction of Zhuhai's supplementary medical insurance product "Daaiwujiang". Then, this paper makes a regression analysis on the comprehensive evaluation index of the satisfaction of the insured based on the two main influencing factors of the insured's perceived quality and perceived value, and finds that the amount of premium, the scope of protection, the level of protection, the consulting services, the claim procedures, the professionalism of window workers, and the reduction of the economic burden of medical expenses have a significant positive impact on the comprehensive evaluation index of satisfaction. Claim settlement procedures and payment standards have a significant negative impact on the comprehensive evaluation index of satisfaction. Finally, this paper uses four quadrant map to locate the influencing factors of satisfaction, and puts forward corresponding suggestions.

参考文献总数:

 73    

馆藏地:

 总馆B301    

开放日期:

 2023-12-24    

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