关键词: 保险, 长期医疗；病人满意度；影响因素分析

Abstract: Background　China's local governments have been outsourcing critical illness insurance services for many years and it is urgent to evaluate the implementation effectiveness.Satisfaction is one of the important measurement aspects.However，domestic research about patients' satisfaction with such services is insufficient.Objective　To perform a comparative analysis of patients' satisfaction with critical illness insurance services delivered by different government outsourcing models and the associated factors，providing a reference for relevant government agencies to improve the implementation policies and strategies.Methods　Data were collected from the critically ill patients information database of T City，Hebei Province.By use of convenience sampling，813 cases who were included in the database from 2014—2016 were selected，and were given a telephone-based or WeChat survey for obtaining their satisfaction level with critical illness insurance services delivered by different government outsourcing models.Multiple linear regression analysis was used to analyze the associated factors for the satisfaction level.Results　Patients with critical illness insurance for working urban residents（CIIWUR）obtained lower mean total score of satisfaction with the insurance，lower mean scores of satisfaction with the standard for pooling funds for the insurance，and satisfaction with the reimbursement procedure，but higher mean score of satisfaction with the reimbursement ratio compared with those with critical illness insurance for urban and rural residents（CIIURR）（P<0.05）．Multiple linear regression analysis showed that mean monthly income and purchase of commercial critical illness insurance were associated with satisfaction with the standard for pooling funds for the insurance in patients with CIIWUR（P<0.05）；education level，awareness level of the critical illness insurance，and purchase of commercial critical illness insurance were associated with satisfaction with the reimbursement procedure in patients with CIIWUR（P<0.05）；mean monthly income and awareness level of the critical illness insurance were associated with satisfaction with the reimbursement ratio in patients with CIIWUR（P<0.05）；awareness level of the critical illness insurance and purchase of commercial critical illness insurance were associated with satisfaction with the CIIWUR services by the insurance company in patients with CIIWUR（P<0.05）．Mean monthly income was associated with satisfaction with the standard for pooling funds for the insurance in patients with CIIURR（P<0.05）；purchase of commercial critical illness insurance and hospitalization due to illness or injury in the past year were associated with satisfaction with the reimbursement procedure in patients with CIIURR（P<0.05）；age，mean monthly income，purchase of commercial critical illness insurance and hospitalization due to illness or injury in the past year were associated with satisfaction with the reimbursement ratio in patients with CIIURR（P<0.05）．Conclusion　The reimbursement of critical illness insurance greatly contributes to patients' total satisfaction，but different outsourcing models of governments have different dimension satisfactions.In view of this，it is encouraged to share the advantages of the two government outsourcing models and to collaboratively overcome their limitations.Moreover，the increase of insured persons' satisfaction level should be listed as one of the value goals of the government outsourcing critical illness insurance services.

Key words: Insurance, long-term care；Patient satisfaction；Root cause analysis