Liu Xiaofang, Cheng Wenwei, Yan Xiaofang, Peng Liai, Song Xiaoxiao, Jiao Feng, Shi Jingcheng, Xiao Xia
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078.
Personnel Office, Wuhan Hospital of Traditional Chinese Medicine, Wuhan 430050.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Jul 28;45(7):840-848. doi: 10.11817/j.issn.1672-7347.2020.190156.
To verify the applicability and extensibility of the satisfaction index of basic medical insurance for rural and urban residents, and to explore the mechanism responsible for the satisfaction index in Kunming and Changsha City, and provide references for effective management and policy making.
A stratified cluster sampling method was conducted. A total of 560 familial decision makers were randomly selected in 24 classes of 14 schools of Kunming and Changsha City. Model reliability was tested by SPSS18.0. In addition, Smart PLS 3.0 was applied to conduct model validity test, calculate the satisfaction index, and to compare the model path coefficients of Kunming and Changsha by multi-group analysis.
In the application of the satisfaction index of basic medical insurance for rural and urban residents in Kunming, Cronbach's α of the model was 0.93, split-half reliability coefficient was 0.90, and the latent variable composite reliability coefficient values were more than 0.86; the latent variable average variance extraction (AVE) values were greater than 0.66, and the square root of the AVE of each latent variable (all greater than 0.66) was larger than the correlation coefficient with other latent variables. The factor loading values were greater than 0.70, with statistical significance. The basic health insurance satisfaction index of Kunming and Changsha was 60.40 and 52.05, respectively. The difference between the path coefficient of Kunming and Changsha was not statistically significant except the path from public satisfaction to public loyalty. Perceived value had the largest direct and total effect on public satisfaction latent variable in Kunming City. While the perceived value had the largest direct effect on public satisfaction, and the perceived quality had the largest total effect on public satisfaction in Changsha City.
The satisfaction index model reflects the satisfaction of pupils' basic medical insurance for urban and rural residents, and it also shows good reliability and validity in Changsha and Kunming. What's more the model can be extended to the national level to evaluate the satisfaction of basic medical insurance for urban and rural residents for primary school students. The basic health insurance satisfaction index of familial decision makers in Kunming is higher than that of Changsha. There are differences between Kunming and Changsha in the influential mechanism of the satisfaction index of for Chinese pupils with basic medical insurance for rural and urban residents, and the measures taken by the government and relevant departments to improve the satisfaction of basic medical insurance should be based on local conditions.
验证城乡居民基本医疗保险满意度指数的适用性和可扩展性,探究昆明市和长沙市满意度指数的影响机制,为有效管理和政策制定提供参考。
采用分层整群抽样方法。在昆明市和长沙市14所学校的24个班级中随机抽取560名家庭决策者。用SPSS18.0检验模型信度。此外,应用Smart PLS 3.0进行模型效度检验,计算满意度指数,并通过多组分析比较昆明市和长沙市的模型路径系数。
在昆明市城乡居民基本医疗保险满意度指数的应用中,模型的Cronbach's α为0.93,分半信度系数为0.90,潜在变量组合信度系数值均大于0.86;潜在变量平均方差抽取(AVE)值大于0.66,各潜在变量AVE的平方根(均大于0.66)大于与其他潜在变量的相关系数。因子载荷值大于0.70,具有统计学意义。昆明市和长沙市的基本医疗保险满意度指数分别为60.40和52.05。除公众满意度到公众忠诚度的路径外,昆明市和长沙市的路径系数差异无统计学意义。在昆明市,感知价值对公众满意度潜在变量的直接效应和总效应最大。而在长沙市,感知价值对公众满意度的直接效应最大,感知质量对公众满意度的总效应最大。
满意度指数模型反映了小学生对城乡居民基本医疗保险的满意度,在长沙市和昆明市也显示出良好的信度和效度。而且该模型可扩展到全国层面,以评估小学生对城乡居民基本医疗保险的满意度。昆明市家庭决策者的基本医疗保险满意度指数高于长沙市。昆明市和长沙市在城乡居民基本医疗保险对中国小学生满意度指数的影响机制方面存在差异,政府及相关部门提高基本医疗保险满意度应因地制宜。