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农民参与新型农村合作医疗的态度研究

Research on Farmers’ Attitude to the New-Type Cooperative Medical Service System in Rural Areas

【作者】 翟玉晓

【导师】 阙祥才;

【作者基本信息】 华中农业大学 , 社会学, 2011, 硕士

【副题名】以山东省莒县为例

【摘要】 新型农村合作医疗制度是由我国政府组织、支持的一项旨在改变农村落后医疗保障现状的村民互助共济医疗救助制度。农民作为新型农村合作医疗的参与主体,对他们参加合作医疗的态度进行研究可以为我国新农合制度的改进和完善提供有益的借鉴,从而更有效地发挥它对农民疾病风险的保障作用。本文在参照大量已有研究成果的基础上,以公共产品理论、社会行动理论、理性选择理论等社会学、经济学理论为依据,运用定量和定性相结合的研究方法,将山东省莒县农村作为调查地,对当地农民参与合作医疗的态度进行了实证调查研究。论文从心理学中态度的构成要素——认知、情感、行为倾向三个方面,对受访农民的参合态度进行了系统考察,并对可能影响农民参合态度的各因素进行了分析。研究表明:第一,在认知方面,农民对新农合的总体认知程度较高,特别是对自身权利与义务、资金筹集方面的认知。另外,农民收集关于新农合政策信息的最主要的途径是村镇基层工作人员的宣讲动员,村镇工作人员的素质与宣传工作能力直接影响着宣传动员效果和农民能否获得对新农合全面、准确的认知。第二,在农民参合态度的情感维度上,农民对现行的新农合制度是基本满意和认可的。但是,调查地农民也表达了要求国家和地方财政加大对合作医疗扶持力度的强烈愿望,并期待新农合制度能够进一步改进和完善。第三,在农民参合态度的行为倾向上,调查地的大多数农民是自愿参加新农合的,并且多数农民也表现出了进一步参加的行为倾向。同时,也有一定比例的农民对此持观望态度,新农合在制度设计和对农民的保障力度上还存在着一定的不足,使农民参合时有所顾虑。第四,农民个体特征(年龄、身体健康状况、职业身份、文化程度、家庭成员外出工作生活情况)、环境(制度环境、医疗环境)、农村文化观念(互助观念、健康风险意识)等因素都对参合态度有影响作用。

【Abstract】 New-type cooperative medical service system in rural areas is a kind of mutual help medical system which is organized and supported by our government and aims on changing the low-level situation of medicare security in rural areas. As the principal part of this medical system, farmers’attitude to the system is of great significance and the study on it will be much helpful to the improvement and consummation of the system so that it can have a better play to deal with farmers’risk of disease.This paper which has been in reference to a large number of previous researches is based on sociology and economic theories such as public product theory, social action theory and rational selection theory. We selected the countryside of Juxian County in Shandong Province as the survey locus and used quantitative and qualitative methods of research to investigate local farmers’attitude to new-type corporative medical service system. From the view of psychology, attitude involves cognition, emotion and intention. Th-is paper opens out respondents’attitude towards new-type cooperative medical system from above three aspects and analyzes the factors which may affect their attitude. The study shows:First, on the aspect of cognition, farmers’general cognition is in a high level, especially in the cognition of rights & obligations and financing work.Otherwise, the major access for farmers to collect information about cooperative medical service is the publicity and mobilization by rural functionaries, and furthermore their publicity work and ability directly affect the result of mobilization and farmers’cognition on the system.Second, on the aspect of emotion, this cooperative medical service system is basically satisfied and approved by farmers. However, in the survey farmers also wish government give larger-scale medical assistance to them and look forward to further improvement for new-type cooperative medical service system.Third, on the aspect of intention, most of the farmers participate into the cooperative medical service system on their own accord, and the majority of them have shown their intention of further participation. Meanwhile, a proportion of the farmers takes a wait-and-see attitude. It shows that still there are some deficiencies in the system design and the degree of compensation which have brought certain doubts to them.Fourth, farmers’individual traits (age, physical fitness, occupation, education level, family structure), environment (system environment, medical environment), rural culture concept (concept of mutual aid, awareness of health risk) have affections to farmers’ attitude towards new-type cooperative medical service system.

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