金融学院知识库

        以“政府积极干预、保险公司市场化运作、居民自愿参保、重特大疾病保障”为特点的城市定制型商业医疗保险，在近几年快速增长，弥补了传统商业健康保险与社会基本医疗保障的空缺，为构建我国多层次医疗保障体系作出重要贡献。兰州市于 2021 年 3 月正式推出“金城·惠医保”，是城市定制型商业医疗保险助力“共同富裕”的重要实践。“金城·惠医保”为构建兰州市多层次医疗保障体系有重要意义，保障方案不断升级，但实施过程中面临投保率不高，没有达到预期。因此，通过对居民参保意愿调查及其影响因素分析，相应提出对策建议，对“金城·惠医保”实现可持续发展和兰州市多层次医疗保障体系的完善具有现实意义。

   本文通过文献研究法、问卷调查法、实证分析法对“金城·惠医保”参保意愿及其影响因素进行研究。主要分为六章内容。第一章介绍了研究背景、研究意义、研究内容、研究方法等，对国内外相关文献进行了评述，指出了本文可能的创新之处和存在的不足之处。第二章对多层次医疗保障体系与城市定制型商业医疗保险进行概念界定，结合健康需求理论，逆向选择理论与计划行为理论进行探讨。第三章阐述“金城·惠医保”的发展现状与不足之处。第四章包括调查问卷的设计、数据收集以及对参保意愿进行分析。第五章根据调查问卷对“金城·惠医保”参保意愿及影响因素进行描述性统计分析，并使用 Logistic 回归模型对参保意愿的影响因素进行实证，结果表明，影响“金城·惠医保”参保意愿的显著性因素有慢性病，家庭人口数量，对未来自己身体状况的感知，“金城·惠医保”的性价比与服务质量。最后，基于研究分析结果，本文提出以下建议:扩宽宣传途径，加强宣传“金城·惠医保”；政府加强制度建设，给予税收优惠，规范信息披露；加强科技应用，提升保险服务水平，有效控制风险；细分人群，细分险种，提供多元化版本服务；发挥体检在事前健康管理的作用；合理设置产品保障水平，升级增值服务。

     The customized commercial medical insurance with Chinese characteristics, characterized by active government intervention, market-oriented operation of insurance companies, voluntary participation of residents, and protection for major diseases, has shown explosive growth in recent years, filling the gap between social basic medical insurance and traditional commercial health insurance, and becoming an important breakthrough in building a multi-level medical insurance system in China. As an important practice of "common prosperity", Lanzhou City officially launched the "Jincheng Huimei Insurance" urban customized commercial medical insurance in March 2021. However, during the implementation process, the insurance coverage rate was not high and did not meet expectations. Therefore, this article conducts a survey on their willingness to participate in insurance and analyzes the factors that affect their willingness to participate, in order to effectively supplement existing literature and also have important significance for the construction of a multi-level medical security system in Lanzhou City.

     This article uses literature research, questionnaire survey, and empirical analysis methods to study the willingness and influencing factors of "Jincheng Hui Medical Insurance" to participate in insurance. It is mainly divided into six chapters. The first chapter introduces the research background, significance, content, and methods, and reviews relevant literature at home and abroad, pointing out the possible innovations and shortcomings of this article. Chapter 2 defines the concept of multi-level medical security system and urban customized commercial medical insurance, and explores it in combination with health demand theory, adverse selection theory, moral hazard theory, and planned behavior theory. Chapter 3 elaborates on the current development status and shortcomings of "Jincheng Huimei Insurance". Chapter 4 includes the design of the survey questionnaire, data collection, and analysis of the willingness to participate in insurance. Chapter 5: Descriptive statistical analysis was conducted on the willingness to participate in the "Jincheng Hui Medical Insurance" based on a survey questionnaire, and the influencing factors were empirically analyzed using a logistic regression model. The results showed that the significant factors affecting the willingness to participate in the "Jincheng Hui Medical Insurance" were chronic diseases, family size, and level of concern about one's future physical condition, The list of special drugs for major diseases and drugs compensated by "Jincheng Hui Medical Insurance" is formulated, and the cost-effectiveness of "Jincheng Hui Medical Insurance" is evaluated. The service quality of staff in answering questions, insurance and other work processes is also evaluated. Finally, based on the research and analysis results, the following suggestions are proposed in this article: broaden the channels of publicity and strengthen the promotion of "Jincheng Huimei Insurance"; The government strengthens institutional construction, provides tax incentives, and regulates information disclosure; Strengthen the application of technology, improve the level of insurance services, and effectively control risks; Segmenting the population, insurance types, and providing diversified version services; Play the role of physical examination in pre health management; Reasonably set product guarantee levels and upgrade value-added services.