Cac nhan to anh hiTofng den quyet dinh tham gia BHYT ho gia dinh
cua ngu'ofi dan tai TP. Tra Vinh
H6 MINH MAN*
Tom tat
Nghiin cffu phdn tich cdc nhdn tdanh hudng de'n quyi't dinh tham gia bdo hiem y ti'(BHYT) cua cdc cd nhdn trong ho gia dinh tgi TP. Trd Vinh. Thong qua khdo sdt 200 ngffdi ddn tgi TP. Trd Vinh. ki't qud nghien cffu cho thdy, nhffng nhdn tddnh hudng di'n quyet dinh tham gia BHYT hg gia dinh cua ngudi ddn theo mffc do gidm ddn. gom: Hieu bii'l vi BHYT; Tmh trgng sffc khoe; Tudi; Solan khdm chffa benh (KCB); Trinh do hgc vdn. Tff do. dexudt cdc gidi phdp tdng ty le bao phu BHYT tren dia bdn TP. Trd Vinh.
Tuf khoa: quye't djnh tham gia. bdo hiem y te. hg gia dinh, TP. Trd Vinh Summary
This research analyzes a number of factors affecting the decision of individuals in Tra Vinh city-based households to participate in health insurance. Through a survey of 200 local people.
the study points out some influential factors arranged in decreasing order of effect, which are Understanding of health insurance; Health status; Age; Number of medical examination and treatment; Educational level. From that finding, solutions are proposed lo increase health insurance coverage in the city.
Keywords: decision to participate in health insurance, household. Tra Vinh city Gldi THIEU
BHYT dtfdc Dang va Nha ntfdc ta xac dinh la rapt trong nhO'ng chinh sach tni cdt trong he thong an sinh xa hpi, gop phdn dam bao chara sdc stfc khde cho ngtfdi dan, co vai tro hd'l stfc thie't thii'e Id bao ve tai chinh trtfdc nhffng rui ro ve bdnh tat cho nhu'ng ngtfdi Iham gia.
Tai Tra Vinh, nhifng ndm gan day, Quy BHYT Ihtfdng xuydn bi rdi vao tinh trang ma't can dd'i, so' tiln thu BHYT khdng du chi tra, thanh todn cho chi phi KCB BHYT, mac dil sd'tiln thu BHYT ndm sau luon cao hdn nam trtfdc, ttfdng iSig vdi sd' ngtfdi raua BHYT khdng ngtfiig tang len.
Theo bao cao cua Bao hiem Xa hpi tinh Tra Vinh, nam 2018, todn Tinh hien cd 988.044 ngtfdi tham gia BHYT chid'm ty le 94,96% dan so'cua Tinh, trong dd rieng nhdm ttf dong (hd gia dinh) mdi dat gan 80%. Hidn v§n dang con hdn 20% ddn sd' cua Tinli chtfa dtfdc tham gia BHYT va h^u hd't thudc nhdm hd gia dinh.
Nhtf vay, dd' ddm bao BHYT phdt huy dtfdc diing tdc dung lich ctfc, giiip
cho viec KCB cua ngtfcfi dan dtfpc thudn ldi, thi viec nghidn eii'u cac nhdn to' anh htfdng de'n quye't dinh tham gia BHYT ho gia dinh cua ngtfdi dan tren dia ban TP. Tra Vinh la thtfc stf can thid't.
CasdLYTHUYETVAMOHINH NGHIEN CLfU Khai ni$m v l BHYT
O Vidt Nam da cd nhieu nhd nghidn ctfu vd hpc gia dtfa ra khdi nidra v l BHYT. Cd quan dilm cho rang, BHYT Id radt chinh sdch xd hpi do Nhd ntfdc to chtfc thtfc hidn nham huy ddng nguon Itfc tai ehinh cua Nhd ntfdc, ngtfdi su' dung lao dpng, ngtfdi lao dpng vd cdng dong de hinh thanh quy chi tra chi phi KCB cho ngtfdi tham gia BHYT theo quy dinh ciia phap lual.
Cdc doanh nghidp bao hiem thtfdng raai ciing trien khai BHYT vd hp cho rang, BHYT la hinh thtfc bao hiem cho nhu'ng chi phi y td' phat sinh Udn quan den nhtfng rui ro ve sd'c khoe cua ngtfdi tham gia bao hiem.
Sd dl cd stf ichdc nhau v l khai nidm la vi:
- BHYT cd hai hinh tiitfc khdc nhau, dd la: BHYT xa hdi va BHYT ttf nhan vi muc neu ldi nhudn. BHYT xa hpi Id mpt chinh sdch xa hpi do Nha ntfdc ban hanh va to chu'c thtfc hien. Hinh thi?c bao hiem ndy khdng vi muc tidu ldi nhudn, ma vi stfc khoe cua cpng dong, giiip cong dong thanh lodn cae chi phi y te'phat sinh, khi gap
' Bao hiem Xa hdi Unh Tra Vinh
Ngdy nhdn bdi: 30/5/2020; Ngdy phdn bien: 08/6/2020; Ngdy duvft d
Economy and Forecasi Review
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HINH 1: MO HINH NGHTEN CflfU DE X O A T
phai rui ro trong cupc song, trong lao ddng san xua't.
Con BHYT ttf nhan thtfdng do cac doanh nghidp bao hiem thtfone mai to chtfc trien khai, rauc tieu ciia hinh thtfc bao hiem nay la ldi nhudn, tinh xa hdi ra't han chd'.
Tuy nhidn, hinh thtfc BHYT ttf nhan van dtfdc irien khai d nhieu ntfdc trdn the' gidi (Nguydn Van Djnh, 2012).
- Vi ly do Irdn, ma phtfdng thtfc huy ddng dd' hinh thanh quy BHYT cung khac nhau. Vdi loai hinh BHYT xa hpi, ngoai cdc cd nhdn va t l chtfc tham gia ddng gdp, Nha ntfdc con hd Ird va bao trd rd't nhieu cho cdc nhdm ddi ttfdng ye'u the', nha't la trong thdi ky dau mdi trien khai va bao trd cho quy BHYT khi can thid't.
Loai hinh BHYT dtfdc nghidn ctfu d day la BHYT xa hdi, VI Viet Nara luon htfdng tdi loai hinh BHYT ndy.
T^ng quan nghidn cihi
Nguyln Vdn Phuc va Cao Viet Ctfdng (2014) da chuhg minh rang, tuoi co tac dpng cd y nghia thong kd dd'n quyd't dinh raua BHYT hp gia dinh eua ngtfdi dan d TP. Ho Chi Minh, dieu ndy cd nghTa la ngtfdi d nhdra tuoi cao hdn cd kha nang mua BHYT nhieu hdn nhom tuoi tha'p.
Nghidn ctfu cua Nguyen Xudn Thang (2017) chi ra mo'i quan he thuan chieu giffa tiinh dp hgc va'n cua chu hp vd quye't dinh tham gia BHYT cua hp gia dinh d huyen Thanh Phu, linh Be'n Tre. Thdm vao do, tdc gia eon chi ra rang, nhan to' stf hieu bid't ve cac chinh sdch BHYT cd tac dpng Idn dd'n quye't dinh tham gia BHYT hd gia dinh.
Cung quan dilm do, theo Le Minh Tuyd'n (2017), vide nhan thii'e nhmig ldi ich cua vide tiiam gia BHYT la vd cung can thiel, cdng tdc tuydn truyin ldi ich cua BHYT to't, giup ngtfdi nhdn Ihtfc dung ve chinh sdch BHYT, tiii vide thara gia BHYT cua ngtfdi dan se tiiuan ldi hdn.
Ngoai ra, Le Canh Bich Thd (2017) nghien cij\i cac nhdn td'anh htfdng de'n quyd't dinh mua BHYT ttf nguyen cua ngtfdi ddn TP. Can Thd chi ra nhan to' so' l^n KCB ngoai tru trong nam eua ngtfdi dtfdc phdng van ldc dpng cung ehieu dd'n quye't dinh mua BHYT ttf nguydn, cu tiie ne'u so'lan KCB tf-ong quy cang cao, thi ngtfdi dan cd xdc sua't mua BHYT ttf nguydn cdng nhieu.
Md hinh nghidn cihi
Thdng qua Itfdc khao cdc nghien cd\i trtfdc. tde gid de xud'l mo hinh nghien ctfu vl 7 nhdn to' anh htfdng
den quye't dinh tiiam gia BHYT hp gia dinh cua ngtfdi dan tai TP. Tra Vinh nhtf Hinh 1.
De CO so Ueu nghien ctfu, tdc gia thtfc hidn khao sat 200 ngtfdi dan bao gom:
(i) Ngtfdi dan chtfa tiiam gia (ddi ttfdng mua tiem nang) BHYT (100 n|tfdi): (") Ngtfdi dan da tiiam gia (cd tiie tidp tuc mua hoac dtfng mua) BHYT (100 ngtfdi).
Nghien etfu khao sdt tren dia ban cdc phtfdng Clia TP. Trd Vinh. gom: Phtfdng 1, 2, 3, 4, 5, 6, 7, 8, 9 va xd Long Dtfc, cdc phtfdng ndy eon cd vi tri dia ly Hen ke nhau, tiiuan ldi cho vide tiiu thdp dl? lieu. Khao sat dtfdc tiitfc hien trong khoang thdi gian itf thdng 08-09/2019.
KET q U A NGHIEN CLfU VA THAO LUAN
D l xdc dinh, do Itfdng va danh gia ratfc dp tdc dpng ciia cac nhdn to anh htfdng dd'n quyd't dinh thara gia BHYT cua cdc ca nhan trong hd gia dinh tren dia ban TP.
Tra Vinh, phtfdng phdp hoi quy Binary logistic dtfde stf dung co 07 nhan to' anh htfdng, bao gora: (I) Fl - Tuoi; (2) F2 - Trinh dd hoc vd'n; (3) F3 - Tinh trang stfc khde; (4) F4 - So lan KCB; (5) F5 - Chi phi kham; (6) F6 - Hilu biet ve BHYT;
(7) F7 - Thdi gian chd de dtfdc khdm, vdi bie'n phu thude (Y) - Quye'i dinh iham gia BHYT. Gia tri cua bid'n phu thupc dtfdc do Itfdng bang hai gid tri I va 0 (1: Ngtfdi dan mua BHYT hd gia dinh; 0: ngtfdi ddn khong mua BHYT hp gia dinh).
Sau khi dtfa 7 bid'n dpc lap vao cung luc de phan tich hoi quy Binary logistic bang phan mim SPSS, cd ke't qua nhtf Bang.
Ket qua phan lich hoi quy Binary logistic cho tiiay, tf-ong 7 bien dtfa vdo phan tich, thi ed 5 bien (Fl, F2. F3, F4 F6) cd he so hoi quy cd Sig. nhd hdn mtfc y nghTa I %, 5% va 10%, itfc la cd y nghia thong ke 1%, 5% vd 10%. Cd nghTa cdc bid'n nay cd anh htfdng de'n quye't djnh tham gia BHYT ciia cac cd nhan trong hp gia dinh tren dia ban TP. Tra Vinh Ngodi ra, xdc sua't dtf bao tning ciia md hinh la 81,0% ttfdng dd'i ldn, gia tri -2LL C-2Log likeUhood) = 159,495 la khd nho the hien mtfc dp phu hdp ciia md hinh vdi long the nghidn ctfti.
Nhtf vay.^kh) dtfa 5 bien dpc lap vdo phdn^u'ch hoi quy Binary logistic, cac he so hoi quy ridng phan deu co y nghTa thong ke d mtfc y nghTa 1%, 5% vd cd gia tri am/dtfdng, chtfng td cdc bi^n doc
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lap cd ttfdng quan thudn/nghich vdi bien ddc phu tiiuoc (Y - Quye't dinh tham gia BHYT). Trong dd, bid'n ddc lap F6 - Hid'u bilt ve BHYT cd he so' tdc dpng bien Idn nhd't (0,755) trong 5 he so hoi quy cua cac bie'n dtfa vao phdn tich ed y nghia thong ke, nen cd anh htfdng manh nhd't de'n bie'n phu tiiupc Quye't dinh tiiam gia BHYT, tilp tiieo lan Itfdt la hd so tac dpng bien etfa bie'n ddc lap: F3 - Tinh trang stfc khoe (-0,449); Fl - Tuoi ( 0 , 2 0 4 ) ; ' F 4 - So lan KCB (0,176) va bid'n dpc ldp F2 - Tiinh dd hpc vd'n (0,112). Nhtf vdy, mudn nang cao quyd't dinh tham gia BHYT cua cac cd nhdn trong ho gia dinh trdn dia ban TP.
Trd Vinh cin tang ctfdng vao cdc nhdn to' anh htfdng da dtfdc chi ra h-ong phan tich Binary logistic trdn, dac bidt chu trpng dd'n nhdn to' nang cao mtfc dd hieu bid't vl BHYT cua ngtfdi dan.
Kd't qua tfdc Itfdng mo hinh hoi quy Binary logistic dtfdc giai thich nhtf sau:
(i) Bien Hieu bie't ve BHYT nhan gia tri 1 (rd'l k6m) dd'n 5 (rd't td't), vdi he sd' |3 ~ 0,755, bid'n nay co anh htfdng raanh nha't dd'n Quyd't dinh tham gia BHYT. Nhiing ngtfdi cd hilu bie't ve BHYT se hilu dtfpc vide tiiam gia BHYT khong chi la quyen ldi, md con la trach nhiem, trdch nhidm vdi ban thdn, gia dinh va cpng ding xd hoi, vi tham gia BHYT se giam bdt rd't nhieu gdnh nang khi d'm dau, benh tat.
(ii) Bie'n Tinh trgng sffc khoe nhan gia tn 1 (Ra't kem) dd'n 5 (Ra't td't), vdi he sd' p = -0,449, bie'n nay cd md'i quan he nghich chilu vdi quye't dinh thara gia BHYT ho gia dinh cua ngtfdi dan tai mu'c y nghia 5%. Tac dpng bien dy/dx = 0,181 nghTa la trong dieu kien cac nhan td'khac khdng ddi, kha nang tham gia BHYT ho gia dinh cua nhihig ngtfdi cd stfc khde td't giam di 18,10 dilm ph^n trdm ve mat xac suS^t so vdl nhtfng ngtfdi cd stfc khoe xa'u.
Dieu nay con cho tha'y, thtfc td', nhifng ngtfdi cd stfc khoe xa'u hdn thtfdng chpn mua BHYT ttf nguyen nhieu hdn nhffng ngtfdi cd stfc khoe td't.
(iii) Bie'n Tudi cd y nghia thd'ng kd d mtfc 1%, he so'tdc dpng bien bang 0,037 mang da'u dtfdng, da'u ky vpng cua bid'n ndy cung ehilu vdi dd'u ky vong ban diu.
Cd thl hilu la tuoi cang cao, thi ngtfdi dan cang quan tdm dd'n vd'n d l stfc khoe cija ban thdn va gia dinh, ndn hp cd nhu cau cao hdn.
(iv) Bii'n Sdldn KCB cd y nghia thdng ke d ratfc 10%, hd sd' p tac ddng dd'n bid'n phu thudc bang 0,176 mang da'u dtfdng
BANG: KET QOA PHAM TICH HOI QUY BINARY LOGISTIC i4,Tgnbign "
Hang so Fl:Tuoi F2: Trinh dfl hoc van F3: Tinh trang siJc khoe F4: Solan KCB F5' Chi phi kham F6: Hieu biet ve BHYT F7- Thcli gian chef de du'dc kham He so Sig.
- 2Log liJceiihood Xac suS^t dif hao triing
B -9 506
0,204 0,112 -0,449 0.176 0,000 0,755 -0,478
d$ng bi^B (dv/dx) 1,997 0,037 0,060 0,181 0.099 0,000 0.353 0,433
Wald 22,660 29,785 3,522 6,138 3,193 1,094 4,563 1,222
Sig.
0,000 0,000***
0,061*
0,013**
0,074*
0,296''=
0,033**
0,269^s EXP(B)
0,000 1.226 1,119 0,638 1.192 1,000 2,127 0,620 0,000 159,495
81,0%
Ghi chd: ***. **, * NS: Miic y nghia 1%. 5%, 10%. khong co y nghia Mguon- Si dung nhtf ky vpng ban dau. He sd dy/dx la 0,099, ttfc la solan KCB cua ngtfdi khao sal tang tiiem 1 lan KCB, till kha nang thara gia BFIYT ttf nguyen theo hp gia dinh cua ngtfdi dan ldng 9,90 diem phan tram. Theo quan sdt thtfc td'trong qua trinh phong va'n, sd'lln KCB trong nam cang cao, thi hp cd xac sud't mua BHYT hd gia dinh nhieu hdn.
(v) Bien Trinh do hgc vdn cd y nghTa ihd'ng kd d mtfc 10%, he sd' P tac dpng bang 0,112 mang da'u dtfdng, dd'u ky vong cua bid'n nay ciing chieu vdi dd'u ky vpng ban d^u. Co the hieu la khi trinh dp hpc van tang ldn, ngtfdi dan se hilu ro rui ro do benh tdt cd thl den luc nao.
Cling nhtf hilu ro lara quan trpng cua stfc khde ban than, raa di KCB khi tha'y stfc khoe cd dau hidu khdng tdt, ttf dd tham gia BHYT hd gia dinh. Ke't qua tfdc Itfdng tde ddng bidn dy/dx = 0,060 cua bid'n nay cho tha'y, neu sd nam di hpc tdng len 1 nam (hay tang thdra 1 ldp), thl xac sua't ngtfdi ddn tham gia tang them 6,0 diem phan tram trong trtfdng hdp cdc nhan to'khdc khong doi.
Md hinh nghidn cihi sau khi tie'n hanh phan lich dtfdc minh hpa nhtf Hinh 2.
KET LUAN VA HAM Y CHINH SACH Ke't qua phan tich hoi quy Binary logistic cho tha'y, nhffng nhan id' anh htfdng dd'n quye't dinh tham gia BHYT hp gia dinh cua ngtfdi dan theo mtfc dp giara dan, gom: Hid'u biet v l BHYT (0,755); Tinh ttang stfc khoe (-0,449); Tudi (0,204); Sd Ian KCB (0,176) va Trinh dp hpc vd'n (0,112).
Tren cd sd cac ket qua nghien ctfu, tdc gia da de xua't 5 nhdm ham y quan in nham gdp phan gia tdng sd Itfdng ngtfdi tham gia BHYT hp gia dinh tren dia bdn TP. Tra Vinh trong tiidi gian tdi.
Mgt Id, cdn tdng sff hieu biet cda ngffdi ddn ve BHYT hg gia dtnh
Hieu bie't v l BHYT hp gia dinh va thu tuc tham gia dtfdc xem la rapt nhdn td'quan trpng trong vide lifa chpn tham gia hay khong tham gia, ttf vide so sanh, danh gia nhffng Idi ich do BHYT hd gia dinh raang lai so vdi mtfc chi phi bd ra; thu luc thtfc hien ddn gian hay phtfc tap, nhflng quy dinh do phap luat ban hanh ve thdi gian
Economy and Forecast Review
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HIMH 1: MO HINH NGHIEN CtfU DE X U A T
phai rui ro trong cuoc sdng, trong lao ddng san xua't.
Cdn BHYT ttf nhdn thtfdng do cac doanh nghiep bao hilm thtfdng mat to chtfc triln khai, rauc tidu cua hinh thtfc bao hiera nay la ldi nhuan, tinh xd hpi rd't han che'.
Tuy nhidn, hinh thtfc BHYT ttf nhan vdn dtfdc trien khai d nhieu ntfdc trdn thd'gidi (Nguyen Van Dinh, 2012).
- Vi ly do tren, ma phtfdng thtfc huy dpng d l hinh Ihanh quy BHYT cung khdc nhau. Vdi loai hinh BHYT xa hdi, ngoai cac ca nhdn vd td chtfc tham gia ddng gop, Nhd ntfdc con hd irp va bdo trd rat nhilu cho cdc nhdm dd'i ttfdng ye'u the', nha't la trong thdi ky dau mdi trien khai va bao trd cho quy BHYT khi can tiiiet.
Loai hinh BHYT dtfpc nghidn eihi d day la BHYT xa hpi, Vl Viet Nara ludn htfdng tdi loai hinh BHYT nay.
T^ng quan nghidn cihi
Nguyln Van Phuc va Cao Viet Ctfdng (2014) da chuhg minh rang, tuoi cd tac dpng cd y nghia thdng ke de'n quyet dinh mua BHYT hp gia dinh eua ngtfdi ddn d TP. Ho Chi Minh, dilu nay cd nghTa Id ngtfdi 6 nhom tuoi cao hon co kha ndng mua BHYT nhieu hdn nhdm tudi thd'p.
Nghien ctfu cua Nguyen Xuan Thang (2017) ehi ra mdl quan he thudn ehieu giffa trinh do hpc van cda chu hd va quyd't dinh tham gia BHYT cua hp gia dinh d huyen Thanh Phu, tinh Ben Tre. Thdm vdo dd, tac gia con chi ra rang, nhan Id' stf hieu bie't ve cac chinh sdch BHYT cd lac dong ldn dd'n quye't dinh tham gia BHYT hp gia dinh.
Cung quan dilm dd, theo Le Minh Tuye'n (2017), viec nhdn thtfc nhffiig Idi ich cua vide Iham gia BHYT la vd cung can Ihie't, edng tac tuyen truyen ldi ich cua BHYT lot, giup ngtfdi nhan thtfc dung ve chinh sdch BHYT, thi vide tiiam gia BHYT cua ngtfdi dan se thuan ldi hdn.
Ngoai ra, Ld Canh Bich Thd (2017) nghien ctfu edc nhan td'anh htfdng dd'n quye'i dinh mua BHYT ttf nguydn cua ngtfdi dan TP. Can Thd ehi ra nhan td so lan KCB ngoai tru trong ndm cua ngtfdi dtfdc phdng va'n tac dpng cung chieu den quyet dinh mua BHYT txi nguyen, cu till ne'u sd lan KCB trong quy cang cao, titi ngtfdi dan cd xdc sua't mua BHYT ttf nguydn cdng nhilu.
M6 hinh nghien cihi
Thdng qua Itfdc khao cac nghien ctfu trtfdc, tac gid de xua't md hinh nghien cd'u v l 7 nhan to anh htfdng
den quyet dinh tham gia BHYT hp gia dinh eua ngtfdi dan tai TP. Trd Vinh nhtf H i n h l . , . , , _
Be cd sd lieu nghien ctfu, tac gia thtfc hien khao sdt 200 ngtfdi dan bao gom.
(i) Ngtfdi dan chtfa tham gia (doi ttfdng mua tilm ndng) BHYT (100 n|tfdi): (n) Ngtfdi ddn da tham gia (cd tiie liep m mua hoac dtfng mua) BHYT (100 ngtfdi).
Nghien ctfu khao sat tren dia ban cac phtfdng cua TP. Trd Vinh, gom: Phtfdng 1. 2, 3, 4, 5, 6, 7, 8, 9 va xa Long^Dtfc, cac phtfdng nay con cd vi tii dia ly hdn k l nhau, thudn ldi cho vide tiiu thap dff lidu. Khao sal dtfdc thtfc hien trong khodng tiidi gian ttf tiiang 08-09/2019.
KET QUA NGHIEN CLfU VA THAO LUAN
De xac dinh, do Itfdng va ddnh gid mtfc dp tdc dpng cua cac nhan td anh htfdng de'n quye't dinh tham gia BHYT cua cdc cd nhan trong hd gia dinh tren dia ban TP.
Tra Vinh, phtfdng phdp hoi quy Bmary logistic dtfdc stf dung cd 07 nhan td anh htfdng, bao gom: (I) Fl - Tuoi; (2) F2 - Tnnh dp hoc van; (3) F3 - Tinh trang stfc khde; (4) F4 - Sd lan KCB; (5) F5 - Chi phi kham; (6) F6 - Hilu biel ve BHYT;
(7) F7 - Thdi gian chd de dtfdc kham, vdi bien phu tiiudc (Y) - Quyet dinh tham gia BHYT. Gid tn cua bien phu thudc dtfdc do Itfdng bang hai gid tri 1 va 0 (1: Ngtfdi dan mua BHYT hp gia dinh; 0: ngtfdi ddn khdng mua BHYT hd gia dinh).
Sau khi dtfa 7 bie'n ddc lap vao ciing luc d l phdn tich hoi quy Binary logistic bdng phan mem SPSS, cd ket qua nhtf Bang.
Ke't qua phan tich hoi quy Binary logistic cho tiia'y, trong 7 bien dtfa vao phan lich, thi cd 5 bien (Fl, F2, F3, F4, F6) cd he sdhoi quy c6 Sig. nhd hdn mtfc y nghTa 1%, 5% va 10%, ttfc Id cd y nghTa thdng ke ] % , 5% vd 10%. Co nghia cdc bien nay cd anh htfdng de'n quye't dinh tham gia BHYT cua cac cd nhan trong hd gia dinh tren dia ban TP Tra Vinh Ngoai ra, xae su^t dtf bdo tning cua md hinh la 81,0% ttfdng ddi ldn, gid tri -2LL (-2Log likelihood) = 159,495 la khd nho the h.?n mtfc dp phu hdp cua md hinh vdi tong tiie nghien ctfu.
Nhtf vay khi dtfa 5 biln doc lap vao phan^ uch hoi quy Binary logistic, cac he so hoi quy rieng phan deu co y nghia thong ke d mtfc y nghia 1%. 5% va cd gid tri am/dtfdng. chtfng td cac biln doc
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lap c6 ttfdng quan thudn/nghich vdi bie'n dpc phu thudc (Y - Quyd't dinh tham gia BHYT). Trong do, bid'n dpc lap F6 - Hieu biet ve BHYT cd he so' tdc ddng bien ldn nhat (0,755) trong 5 he sd hoi quy cua cac bien dtfa vao phan tich cd y nghTa thdng kd, ndn c6 dnh htfdng raanh nha'l de'n bid'n phu thudc Quyet djnh thara gia BHYT, tiep theo Ian Itfdt la he sd tac ddng bien cua bie'n ddc lap: F3 - Tinh trang stfc khoe (-0,449); Fl - Tudi (0,204); F4 - So lan KCB (0,176) va bie'n ddc lap F2 - Trinh dp hpc van (0,112). Nhtf vay, mudn nang cao quye't dinh tham gia BHYT cua cdc ca nhan trong hd gia dinh tren dia ban TP.
Tra Vinh c^n tang ctfdng vao cac nhan td anh htfdng da dtfdc chi ra trong phdn tich Binary logistic irdn, dac biet chu trpng den nhan td nang cao mtfc dp hieu bie'l ve BHYT ciia ngtfdi dan.
Ke't qua tfdc Itfdng md hinh hdi quy Binary logistic dtfdc giai thich nhtf sau:
(i) Bii'n Hieu bii'l ve BHYT nhan gia tri 1 (rd'l kera) den 5 (ra't td't), vdi he sd P = 0,755, bie'n nay cd anh htfdng manh nha'l din Quye't dinh tham gia BHYT. Nhffng ngtfdi cd hieu bie't ve BHYT se hieu dtfpc viec tiiam gia BHYT khong chi la quyen Idi, ma con la trach nhiem, trdch nhidm vdi bdn than, gia dinh va cdng ddng xa hpi, Vl tiiam gia BHYT se giam bdt ra't nhieu ganh nang khi dm dau, benh tdt.
(ii) Bii'n Tinh trgng sffc khoe nhan gia tri 1 (Rd't kem) den 5 (Ra't tdt), vdi he sd p = -0,449, bie'n nay cd md'i quan he nghich chieu vdi quyet dinh tham gia BHYT hp gia dinh cua ngtfdi dan tai mtfe y nghTa 5%. Tac dpng bien dy/dx = 0,181 nghia la trong dieu kidn cac nhan td'khac khdng ddi, kha nang tham gia BHYT hO gia dinh cua nhflng ngtfdi co stfc khoe tdt giam di 18,10 dilm phan tram ve mat xac sud't so vdi nhffng ngtfdi cd stfc khoe xd'u.
Dilu nay con cho tha'y, thtfc td', nhflng ngtfdi cd stfc khoe xd'u hdn thtfdng chpn mua BHYT trf nguyen nhieu hdn nhffng ngtfdi CO stfc khde td't.
(iii) Bie'n Tudi cd y nghTa thdng ke d mtfc 1%, hd sd tdc ddng bien bang 0,037 mang da'u dtfdng, da'u ky vpng cua bie'n nay cung ehieu vdi da'u ky vpng ban dau.
Cd till hieu la ludi cdng cao, thi ngtfcfi dan cang quan tam de'n vd'n de stfc khoe ciia ban than vd gia dinh, nen hp co nhu cau cao hdn.
(iv) Bien Sdldn KCB eo y nghTa tiid'ng ke d ratfc 10%, hd sd p tdc ddng din bien phu thupc bang 0,176 raang dd'u dtfdng
BANG: KET QUA PHAN TICH HOI QUY BINARY LOGIS-HC Ten bign
Hiin^ so Fi.Tuoi F^ Tnnh do hoc van F3: Tinh trang sifc khoe F4: So lan KCB F5' Chi phi kham F6, Hieu biet ve BHYT F7- Thdi Stan chti lie di/Ot: khatii He so Sig
- 2Log likelihood Xtic sua't dtf bao tnjng
HI ser B -9.506
0,204 0,1 P -0,449 0,176 0,000 0,755 -0.478
HlsSrUc 1,997 0,037 0,060 0,181 0,099 0,000 0,353 0,433
Wald 22,660 29,785 3,522 6,138 3,193 1,094 4,563 1,222
' Sig.
0,000 O.OOO"**
0,061*
0 , 0 1 3 "
0,074*
0,296"' 0,033»*
0,269"
EXPOS) 0,000 1.226 1,119 0,638 1,192 1,000 2,127 0,620 0,000 159,495
81,0%
^ NS: Miic :^ nghta 1%, 5%, 10%, khdng id y nghia.
dung nhtf ky vpng ban dau. He sd dy/dx la 0,099, ttfc Id sdlan KCB cua ngtfdi khao sat lang them 1 Ian KCB, till kha nang tham gia BHYT M nguyen tiieo hp gia dinh ciia ngtfdi ddn tang 9,90 dilm phan tram. Theo quan sat thtfc td'trong qua trinh phong va'n, sd'lan KCB trong nam cang cao, till hp cd xac sua't mua BHYT hp gia dinh nhilu hdn.
(v) Bie'n Trinh do hgc vd'n cd y nghia thdng ke d mtfc 10%, he sd p tdc ddng bang 0,112 mang dd'u dtfdng, dau ky vpng ciia bid'n nay ciing chieu vdi da'u ky vpng ban dau. Co the hieu la khi trinh dp hpc van tang len, ngtfdi dan se hieu ro riii ro do benh tat cd thl dd'n luc nao, cung nhtf hilu rd lara quan trpng cua stfc khde ban than, md di KCB khi tha'y stfc khoe cd da'u hieu khdng tdt, tH dd tham gia BHYT hd gia dinh. Ke't qua tfdc Itfdng lac ddng bien dy/dx = 0,060 cua bien nay cho tha'y, neu sd nara di hpc tang ldn 1 ndm (hay tdng thera 1 ldp), thi xac sua't ngrfdi dan tham gia tdng thdra 6,0 diem phan tram trong trrfdng hdp edc nhdn td'khac khdng ddi.
Md hinh nghien etfu sau khi tid'n hanh phdn tich dtfdc minh hpa nhtf Hinh 2.
KET L U A N VA HAM Y CHINH SACH Ke't qua phan tich hoi quy Binary logistic cho thd'y, nhihig nhdn id anh htfdng de'n quye't dmh tham gia BHYT hd gia dinh cua ngtfdi dan theo mtfc dp giam dan, gdm': Hieu bie't v l BHYT (0,755); Tinh trang stfc khoe (-0,449); Tudi (0,204); Sd lan KCB (0,176) va Trinh dp hoc va'n (0,112).
Tren cd sd cac kd't qua nghidn ctfu, tde gia da de^
xud'l 5 nhdm ham y quan tri nhdm gop phan gia tang sd Irfdng ngrfdi tham gia BHYT ho gia dinh trdn dia ban TP. Trd Vinh trong tiidi gian tdi.
Mgt Id, cdn tdng sff hieu biei cua ngffdi ddn ve BHYT hg gia dinh
Hieu bie't ve BHYT hd gia dinh vd tiiu tue tiiam gia dtfdc xem la mdt nhdn tdquan trpng trong viec Irfa chpn thara gia hay khdng tiiam gia, ttf vide so sanh, danh gid nhflng ldi ich do BHYT hd gia a n h mang lai so vdi mtfc chi phi bd ra; thu tuc tiitfc hien ddn gidn hay phtfc tap, nhflng quy dinh do phdp ludt ban hdnh ve tiidi gian
Economy and Forecast Review
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HJNH 1: « 6 HiNH NGHIEN C(i(l DE XOAT
phai rui ro trong cudc sdng, trong lao dong san xud't.
Con BHYT ttf nhdn thtfdng do cdc doanh nghiep bao hilm thtfdng mai td chtfc trien khai, muc tidu cua hinh thtfe bao hiem nay la ldi nhuan, tinh xa hpi ra't han ehd'.
Tuy nhidn, hinh thtfc BHYT ttf nhan vin dtfdc trien khai d nhieu ntfdc trdn thd'gidi (Nguydn Vdn Dinh, 2012).
- Vi ly do trdn, ma phtfdng thtfc huy ddng de hinh thanh quy BHYT cung khac nhau. Vdi loai hinh BHYT xa hdi, ngodi cdc ca nhdn va td chtfc tham gia ddng gdp, Nha ntfdc cdn hd trd va bao trd ra't nhieu cho cac nhdm dd'i trfdng ye'u the', nha'l la trong thdi ky dau mdl trien khai va bao trd cho quy BHYT khi can tiiiet.
Loai hinh BHYT dtfdc nghidn ctfu d day la BHYT xa hdi, vi Viet Nara ludn htfdng ldi loai hinh BHYT nay.
Tdng quan nghidn cihi
Nguyen Van Phue vd Cao Viet Ctfdng (2014) da chtfng minh rdng, tuoi co tac ddng cd y nghTa thdng kd dd'n quyet dinh mua BHYT hp gia dinh ciia ngtfdi dan d TP. Ho Chi Minh, dieu ndy co nghia la ngtfdi d nhdm tudi cao hdn cd kha nang mua BHYT nhieu hdn nhdm ludi thd'p.
Nghidn ctfu cua Nguyen Xuan Thang (2017) chi ra md'i quan he ihuan chilu gifla trinh dd hpc van cua chu hd va quye't dinh tham gia BHYT cua hd gia dinh d huyen Thanh Phu, linh Bd'n Tre. Them vao do, lac gid con chi ra rdng, nhan to' stf hilu bie't ve cac chinh sdch BHYT cd tdc ddng ldn de'n quye't dinh tiiara gia BHYT hd gia dinh.
Cung quan diem dd, theo Le Mmh Tuyen (2017), viec nhan thtfe nhiihg Idi ich ciia viec tiiam gia BHYT Id vd cung can thid't, cdng tdc tuyen truyin ldi ich cua BHYT td't, giup ngtfdi nhdn thtfc dung vl chinh sach BHYT, till viec tiiam gia BHYT eua ngtfdi ddn se tiiudn ldi hdn.
Ngoai ra, Le Canh Bich Thd (2017) nghidn etfu cae nhan tdanh htfdng de'n quye't dinh mua BHYT ttfnguyen cua ngtfdi dan TP. Can Thd chi ra nhan td so lan KCB ngoai tru trong nara cua ngtfdi dtfde phong van lac dpng^
CLing chilu dd'n quye't dinh mua BHYT trf nguydn, cu till ne'u so lan KCB trong quy cdng cao, thi ngtfdi dan cd xac sud't mua BHYT ttf nguyen cdng nhieu.
Md hinh nghidn cihi
Thong qua Itfdc khao cac nghien ctfti trtfdc, lac gia d l xua'l md hinh nghien etfu v l 7 nhdn to' anh hrfdng
den quye'i dinh tiiam gia BHYT ho gia dinh cua ngtfdi dan tai TP. Tra Vinh nhtf
H i n h l . . , . , ^ D l cd sdUdu nghien ctfu, tdc gia thtfc
hien khdo sdt 200 ngrfdi dan bao gom.
(i) Ngtfdi ddn chtfa tiiam gia (doi trfdng mua tilm ndng) BHYT (100 n|tfdi); (n) Ngtfdi dan da tham gia (co tiie hep tyc mua hodc dtfng mua) BHYT (100 ngtfdi).
Nghien etfu khao sat tren dia ban cac phtfdng cua TP. Trd Vinh, gdm: Phtfdng 1, 2, 3, 4, 5. 6, 7, 8, 9 va xa Long Btfc, cdc phrfdng nay con cd vi tri dja Iy lien ke nhau, tiiuan Idi cho vide thu thdp dfl lieu. Khao sdt dtfdc thtfc hien trong khoang thdi gian ttf tiidng 08-09/2019.
KET q U A NGHIEN CLfU VA THAO LU/^N
D l xdc dinh, do Itfdng va danh gia ratfc dp lac ddng cua cdc nhan td anh htfdng dd'n quyet dinh tham gia BHYT eua cac ca nhdn trong hp gia dinh tien dia ban TP.
Tra Vinh, phtfdng phap hoi quy Binary logistic dtfdc stf dung cd 07 nhan td anh htfdng, bao gdra' (1) Fl - Tudi; (2) F2 - Trinh dd hoc van; (3) F3 - Tinh trang stfc khoe; (4) F4 - Sd \in KCB; (5) F5 - Chi phi khdra; (6) F6 - Hilu biet ve BHYT;
(7) F7 - Thdi gian chd de dtfdc khara, vdi bie'n phu tiiudc (Y) - Quyet djnh tham gia BHYT. Gia tri ciia bien phu thudc dtfdc do Itfdng bang hai gia Ui 1 va 0 (1: Ngtfdi dan mua BHYT hp gia dinh; 0: ngtfdi dan khdng mua BHYT hp gia dinh).
^ Sau idii dtfa 7 bie'n dde lap vao cung luc d l phdn tich hdi quy Binary logistic bdng phan mem SPSS, eo ket qua nhtf Bang.
Ke't qua phan tich hoi quy Binary logistic eho tiid'y, trong 7 bien drfa vdo phan tich, tiii cd 5 bien (Fl, F2, F3, F4, F6) cd he sd hdi quy cd Sig. nhd hdn mtfc y nghTa 1%, 5% va 10%, ttfc la cd y nghTa thong kd 1%, 5% vd 10%. Co nghTa cac bien ndy cd anh htfdng de'n quydt dinh thara gia BHYT cua cdc ca nhdn trong hd gia dinh tren dia bdn TP Tra Vinh hmh la 81.0% ttfdng ddi ldn, gia tri -2LL (-2Log hkeltiiood) = 159,495 la kha nho the hi?n mtfc dd phii hdp cua rao hinh vdi long tiie nghien eihi.
Nhtf vay khi dtfa 5 biln ddc ldp vdo phdn^tich hoi quy Binary logistic, cdc he so hoi quy rieng phdn deu c6 ^ nghTa thong ke d mtfc y nghia 1%, 5% vd cd gia tn am/drfdng. chtfng td cdc bie'n doc
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ldp c6 ttfdng quan thuan/nghich vdi bie'n ddc phu thudc (Y - Quyd't dinh tham gia BHYT). Trong dd, bien ddc ldp F6 - Hilu bid't ve BHYT cd he so' tac ddng bien Idn nh^t (0,755) trong 5 he sdhdi quy cua cdc bie'n dtfa vao phdn tich co y nghia thd'ng ke, ndn cd anh htfdng manh nha't den bid'n phu thudc Quye't dinh tham gia BHYT, tie'p theo lin Irfdt la he sd tdc dpng bien cua bid'n ddc lap: F3 - Tinh trang stfc khoe (-0,449); Fl - Tuoi (0,204); F4 - Sd lan KCB (0,176) va bien ddc Idp F2 - Trinh dd hpc vd'n (0,112). Nhtf vdy, mudn ndng cao quyd't dinh tham gia BHYT cua cac ca nhdn trong hp gia dinh trdn dia ban TP.
Tra Vinh cin tang ctfdng vao cac nhan td' dnh hrfdng da drfdc chi ra h-ong phdn tich Binary logistic trdn, dac bidt chu trpng de'n nhan td' nang cao ratfc dd hilu bie't ve BHYT eua ngrfdi dan.
Kd't qua tfdc Itfdng rad hinh hdi quy Binary logistic dtfdc giai thich nhtf sau:
(i) Bien Hieu bie't ve BHYT nhan gia In 1 (rd't kdm) dd'n 5 (rd't tdt), vdi he sd p = 0,755, bid'n nay co anh hrfdng manh nha't den Quyd't dinh tiiam gia BHYT. Nhflng ngrfdi cd hilu bid't ve BHYT se hilu dtfdc vide tham gia BHYT khdng chi la quyen Idi, ma con Id trach nhiem, trach nhiem vdi ban thdn, gia dinh va cpng ddng xa hdi, vi tham gia BHYT se giam bdt rd't nhieu gdnh nang khi d'm dau, benh tdt.
(ii) Bien Tinh trgng sffc khoe nhan gia iri 1 (Ra't kem) de'n 5 (Ra't tdt), vdi he so' p = -0,449, bie'n nay cd md'i quan he nghich chilu vdi quye't dinh tham gia BHYT hd gia dinh cua ngtfdi ddn tai mtfc y nghTa 5%. Tdc ddng bien dy/dx = 0,181 nghTa la trong dilu kien cac nhdn td'khac khdng ddi, kha ndng tham gia BHYT hp gia dinh cua nhflng ngrfdi cd stfc khde to't giam di 18,10 diem ph^n trara ve mat xac sud't so vdi nhffng ngtfdi cd stfc khoe xa'u.
Dieu nay cdn cho tha'y, thtfc te', nhflng ngrfdi cd stfc khoe xa'u hdn thtfdng chpn mua BHYT ttf nguydn nhieu hdn nhflng ngtfdi cd stfc khoe tdt.
(iii) Bie'n Tudi cd y nghTa thdng kd d mtfc 1%, hd sd'tdc ddng bien bang 0,037 mang da'u dtfdng, da'u k>' vpng cua bie'n nay cung chieu vdi da'u ky vpng ban dau.
Cd till hilu Id tudi cang cao, thi ngtfdi dan cang quan tam de'n vd'n de stfc khde cija ban thdn vd gia dinh, nen hp cd nhu cau cao hdn.
(iv) Bien Sdldn KCB cd y nghTa tiidng kd d ratfc 10%, he so' p tac ddng de'n bid'n phu tiiudc bang 0,176 mang da'u dtfdng
BANG: KET QUA PHAN TICH HOI QUY BINARY LOGISTIC T6n bife'n
Hang so FI:Tu^i F2: Trinh dfl hoc van F3: Tmh trang siJc khoe F4. So Iln KCB F5: Chi phf khdm F6: Hilu biet ve BHYT F7 Thdi gian chd de dUtJc kham He so Sig.
- 2Log Ukelihood Xac suS't diT bao tning
H^sd' -9 506 0,204 0,112 -0,449 0,176 0,000 0,755 -0,478
HgsS'tac d$ns bign (dy/dx)
1,997 0,037 0,060 0,181 0,099 0,000 0,353 0,433
Wald 22,660 29,785 3,522 6,138 3.193 1,094 4.563 1,222
Sig.
0,000 0,000***
0,061*
0,013**
0,074*
0,296'^*
0,033**
0,269^^5 EXP(B)
0,000 1,226 1.119 0,638 1,192 1,000 2,127 0,620 0,000 159,495
81,0%
Ghi chu. ***, **, *, NS. Miic y nghia J%, 5%. 10%, khdng co y nghia.
hgu6n: So liSu khao sat dung nhtf ky vpng ban dau. Hd sd dy/dx Id 0,099, ttfc la
sd'lan KCB cua ngtfdi khao sat tang them 1 Ian KCB, thi kha nang tiiam gia BHYT ttf nguyen theo hp gia dinh cua ngtfdi dan tang 9,90 diem phan tram. Theo quan sat tiitfc Id'trong qud tnnh phong va'n, sdlan KCB trong nam cang cao, thi hp cd xdc sua't mua BHYT hd gia dinh nhilu hdn.
(v) Bii'n Trinh dd hgc vdn c6 y nghTa Ihd'ng ke d mtfc 10%, he so'P tdc dpng bang 0,112 mang da'u dtfdng, da'u ky vpng cua bid'n nay ciing chilu vdi dd'u ky vpng ban dau. Cd thl hieu la khi trinh dp hpc van lang len, ngtfdi dan se hieu rd rui ro do benh tat cd thl de'n luc ndo, cung nhtf hilu ro lara quan trpng cua stfc khde ban than, md di KCB khi thd'y stfc khoe cd da'u hieu khdng tdt, ttf do tham gia BHYT hd gia dinh. Ket qua tfdc Itfdng tdc dOng bien dy/dx = 0,060 cua bid'n nay cho thd'y, nd'u sd nam di hpc tang ldn 1 ndm (hay tang them 1 ldp), thi xdc sua't ngtfdi dan tham gia tang them 6,0 dilm phan tram trong trtfdng hdp cdc nhdn td'khac khdng ddi.
Md hinh nghien ciJu sau khi tiln hanh phan lich dtfdc mmh hpa nhtf Hinh 2.
KET LUAN VA HAM Y CHINH SACH Ket qua phdn lich hdi quy Binary logistic cho tha'y, nhtfng nhan td anh htfdng dd'n quyet dinh thara gia BHYT hp gia dinh cua ngtfdi dan iheo mtfc dp giara din, gdm: Hilu bie't ve BHYT (0,755); Tinh trang stfc khoe (-0,449); Tudi (0,204); So lan KCB (0,176) va Trinh do hpe va'n (0,112).
Tren cd s6 cac ke't qua nghien ctfu, tac gia da de xua't 5 nhdm hdm y quan tri nham gdp phan gia tang sd' Itfdng ngtfdi tham gia BHYT hd gia dinh tren dia ban TP. Tra Vinh trong thdi gian tdi.
Mgt Id, cdn tdng sU hieu biei cda ngidfi tidn ve BHYThg gia mnh
Hilu bid't v l BHYT hp gia dinh va thu tuc tham gia dtfdc xem la mdt nhdn tdquan trpng trong vide Irfa chpn thara gia hay khdng tham gia, ttf vide so sanh, danh gia nhtfng Idi ich do BHYT hd gia dinh raang lai so vdi mtfc chi phi bo ra; thu tuc thrfc hidn ddn gian hay phtfc tap, nhu^g quy dinh do phdp lual ban hanh ve thdi gian
Economy and Forecast Revi
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HINH 2: MO HINH NGHIEN CCSU CGOl CONG
i: Tac gia de xuat
tham gia d l dtfdc htfdng quyen ldi... Vi tiie', can cd ke hoach tuydn truyen hdp ly den vdi ta't ca ngrfdi ddn, nhat la cdc thanh phan trong xd hdi de hp drfdc hidu ro chinh sdch ve BHYT hd gia dinh.
Rieng tren dia ban, Bao hiem Xa hdi TP. Trd Vinh cin ldng crfdng giao due, tuyen truyen de'n ngtfdi ddn v l chinh sach BHYT hd gia dinh va htfdng dan cho hp ve cac thu tuc, cung nhtf cae ldi ich cua viec tham gia la dilu quan trong de gia tang so'ngrfdi dang ky tham gia BHYT hd gia dinh. VT vdy, Bao hiera Xd hpi TP.
Tra Vinh can dao tao dpi ngu tuyen truyen cd ky ndng, kie'n thtfc va cham sdc tdt cho "khach hang" nham trf van cho hp bid't v l chinh sdch, hilu drfdc cac ldi ich khi tham gia BHYT hd gia dinh.
Hai Id, tdng ci^ng cong tdc tuyen truyen vd phd bien chink sdch phdp luat ve BHYT
Cdng tdc tuydn truyen va phd biln chinh sach phap ludt vl BHYT CO tac dpng Idn nha't den srf tham gia BHYT hd gia dinh cua ngrfdi dan. Vi the, can cd nhiSig giai phdp hdnh dong thid't thtfc d l nang cao cdng tdc tuyen truyin, cu the nhtf sau:
- Bao hiera xa hpi cdc ed'p phai phd'i hdp vdi cac ngdnh chtfc nang, cd quan bao ehi, dai tmyen hinh, dai truyin tiianh lam td't cdng tac thdng tin tuyen truyen de mpi ngtfdi hieu va tiiam gia BHYT ho gia dinh. Hien nay, vdi stf phat triln cua ede phrfdng thtfc truyen thdng,
thdng tin lien lac. can quang bd ldi ic ^„
BHYT ho gia dinh tfen cac trang n|^"A hpi, nhtf: You Tube, Faeebook. Zalo Dai g nhflhg hinh anh than tiiidn va noi dung hut ngtfdi dan.
- Bao hiera Xa hdi Tinh can co ly cd tnnh dd, nang Itfc chuyen i phat triln ddi ttfdng BHYT ho gia
. cic dai mdn v l dinh.
Cd quan bao hiem xd hpi chu dpng tranh thu" stf chi dao vdi cap uy, chinh quyin, doan t h l cap xd, phtfdng, thi tran van dpng tdt, thi ngtfdi ddn ddng ky tham gia rat cao.
Ba Id, ndng cao chd't lUdng cd sd vdt chdi, phitc vu, dich vti cua cdsdKCB
Cd quan bao hilm xa hdi can xay diJfng lieu chi danh gia chd't Itfdng bdnh vidn, thai dd phuc vu cua cdn bp, nhdn vidn y te'„. Tham chi, co the tien hdnh xdy dtfng mdu khao sat tiidng nhd't v l cha't Itfdng KCB khi stf dung the BHYT. Tren cd sd nay, Bao hilm Xd hdi Tinh tien hanh dilu ti:a, tiiu tiiap y kien v l KCB cua ngtfdi cd the BHYT. Ke't qua danh gia cua ngtfdi bdnh nay se tid thanh mot trong nhiSiig tieu chi quan trpng d l cac cd s6 KCB kip thdi chd'n chinh, cai each thu tuc hdnh chinh, nang cao chd't Itfdng phuc vu.
Bon Id, hodn thi$n chink sdch ho trd cua Nhd nUdc
Ddy Id loai hinh bao hiemxa hdi phi Ihrfdng mai nhara chia se, hd trd cpng ddng. Do vdy, thdi gian tdi, cd quan bao hilm xa hdi can phd'i hdp cac cap ed tham quyin yd ban, nganh cd lien quan kiln nghi dilu chinh chinh sdch BHYT hd gia dinh, stfa ddi, bo sung quy dinh; cd the hd trd rapt phan kinh phi cho nhdm hp gia dinh cd mtfc ihu nhap tha'p, ciing nhtf Idi ich dtfdc htfdng pliij hdp, ttf do hd'p dan ngtfdi tham gia.Q
TAI LI5:U THAM KHAO
1. Bao hilm Xa hpi TP. Trd Vinh (2019). Bdo cdo tdng ki't ndm 2019
2. Nguyln Van Dinh (2012)^ Gido trmh bdo hiem, Nxb Dai hpc Kinh t l Qud'c dan. Ha Noi 3. Hoang Trpng, Chu Nguydn Mdng Ngoc (2008). Phdn tich dff lieu nghiin cffu vdi SPSS tao 1 vd 2, Nxb Hdng Dtfc, TP. Ho Chi Mmh " '^
4. Ld Minh Tuyd'n (2017). Nghien cffu cdc nhdn tdtdc dgng denjutham gia BHYT cua ndng dan tren dia bdn TP. Hd Ndi, Ludn an tid'n sy, Trtfdng Dai hpc Kinh te Qudc dan
5. Nguydn Vdn Phuc, Cao Viet Ctfdng (2014). Thdng tin bat cdn xtfng. lua chpn ngtfdc vd rui ro dao dtfc: Nghien culi trtfdng hdp mua vd stf dung the BHYT td nguydn trdn dja ban TP. Hd Chi Minh, Tgp cbi Kinb leva Phdt trien, 208, 9-16
6. Nguyln Xudn Thang (2017). Cac nhdn td vdn hda anh htfdng den viec tham gia BHYT- Trtfdng hdp huyen Thanh Phu, Bd'n Tre, Tap chi Kinh te'vd Dff bdo. sd 33, thang 11/2017
7. Le Canh Bich Thd (2017). Cac nhan tdanh htfdng den quyet djnh mua BHYT ttf nguygn cd
ngrfdi ddn TP. Can Thd, Tap chi Khoa hoc Trffdng Dgi hgc Cdn Tha. 48d, 20-25 ^
