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To explore the cognition of medical staff within the tightly-knit county-level medical consortium in Xinyi County, Jiangsu Province regarding the reform of medical insurance payment methods and the influencing factors, and to provide references for deepening the reform of medical insurance payment methods within the medical consortium.
By using stratified cluster sampling method, a questionnaire survey was conducted among 1 415 medical staff within the medical consortium of Xinyi City from October 2021 to January 2022. The random forest model was employed to screen variables and multivariate logistic regression analysis was conducted to analyze the influencing factors.
Medical staff had a relatively high level of understanding of the medical insurance payment methods of disease-based payment (87.1%) and service-item-based payment (74.3%); they had a relatively high level of recognition of the medical insurance payment methods of disease-based payment (75.1%) and bundled payment based on medical consortium (51.7%). 91.7% of the medical staff were relatively familiar with the reform. The working institutions were township health centers and community health service centers (OR=2.300, 95% CI: 1.205-4.391), and medical staff with senior professional titles or above (OR=4.701, 95% CI: 1.610-13.727) had a relatively high level of understanding of the reform. 81.5% of the medical staff expressed their recognition of the reform. Doctors (OR=2.032, 95% CI: 1.459-2.828), nurses (OR=1.638, 95% CI: 1.073-2.501), medical staff with a master's degree or above (OR=2.399, 95% CI: 1.050-5.480), and medical staff with shorter working years (OR11-15years=0.546, 95% CI: 0.327-0.911; OR16-20years=0.516, 95% CI: 0.285-0.932; OR≥21years=0.443, 95% CI:0.272-0.722) had a relatively high level of recognition of the reform.
The level of awareness and acceptance of new payment methods such as bundled payment for total medical expenses by medical staff within the tightly-knit county-level medical consortium still needs to be improved. It is suggested that measures such as stratified training and the introduction of talent incentive policies for grassroots medical institutions be adopted to enhance the awareness and recognition of medical staff.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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