克罗地亚公民对健康保险的看法。

Mastilica Miroslav, Babić-Bosanac Sanja

Department of Medical Sociology, Andrija Stampar School of Public Health, Zagreb University School of Medicine, Rockefellerova 4, 10000 Zagreb, Croatia.

Croat Med J. 2002 Aug;43(4):417-24.

AIM

To examine the citizens' attitudes toward health insurance and its reform in Croatia, and their views on private payments for health care services.

METHOD

In 1999 and 2000, we surveyed 500 randomly selected adults from all regions of Croatia, aged 40 years and over. The questionnaire included questions on social health insurance, private payments for health care, and background information. The net response was 393 (79%). The analysis of the data collected included univariate and multivariate analyses to test the differences in the attitudes among sociodemographic and socioeconomic groups.

RESULTS

Most interviewed Croatian citizens (83.2%) expressed the opinion that everybody should have access to health care services, irrespective of the health insurance contributions. However, 32.1% agreed that the utilization of services should depend on the payment of contribution; 39.1% believed that the money they contributed to health insurance corresponded to health care services they received; 60.1% agreed that insurance rate should increase proportionally to income. When asked about reforms, more than half (53.4%) thought that the current health insurance covered less benefits than 10 years earlier, whereas more than a third believed that changes offered more choice (36.9%) but less equity (37.7%), and 46% disagreed with the introduction of the basic package of health care benefits and supplementary insurance. About the same percentage of respondents thought that they had already been paying too much for health care out of their own pockets.

CONCLUSION

Citizens in Croatia do not hold a positive opinion on health insurance reform. They fear the changes would bring about limitations in their social rights and increase their financial burden.

目的

调查克罗地亚公民对健康保险及其改革的态度，以及他们对医疗服务私人支付的看法。

方法

1999年和2000年，我们从克罗地亚所有地区随机抽取了500名40岁及以上的成年人进行调查。问卷包括有关社会健康保险、医疗服务私人支付以及背景信息的问题。有效回复为393份（79%）。对收集到的数据进行的分析包括单变量和多变量分析，以检验社会人口统计学和社会经济群体之间态度的差异。

结果

大多数接受采访的克罗地亚公民（83.2%）表示，每个人都应能获得医疗服务，无论其健康保险缴费情况如何。然而，32.1%的人同意服务的使用应取决于缴费情况；39.1%的人认为他们缴纳的健康保险费与所获得的医疗服务相对应；60.1%的人同意保险费率应与收入成比例增加。当被问及改革时，超过一半（53.4%）的人认为当前的健康保险覆盖的福利比10年前少，而超过三分之一的人认为改革提供了更多选择（36.9%）但公平性降低（37.7%），46%的人不同意引入基本医疗福利套餐和补充保险。大致相同比例的受访者认为他们自己已经为医疗支付了太多费用。