目的: 了解北京市老年人群的医疗保障利用与评价情况,并分析其影响因素,为完善医疗保障制度、实现健康老龄化提供决策依据。方法: 通过对在北京市6家不同等级医疗机构就诊的老年人进行问卷调查,获得老年人参保、医保使用、就医行为以及对医保满意度评价情况,并使用卡方检验和多因素logistic回归分析老年人群医保满意度影响因素。结果: 被调查的老年人参保率和医保使用率均较高,在报销方式上更倾向于人工缴费窗口。职工医保老年人就近就诊符合率较低。对于医保异地报销表示很不满意和不了解的老年人较多。健康状况水平、职工医疗保险和居民医疗保险能够显著影响老年人对北京市医保服务的满意度。结论: 建议进一步提升老年人参保率和医保使用率,协同推进分级诊疗与医保制度配套,充分发挥政策叠加效应,促进医疗资源的合理配置与利用,并继续普及和完善医保异地就医制度,提升居民医保的待遇水平,促进职工医保与居民医保的融合,最终推进医保高质量发展和健康老龄化。

Objective: The paper investigates the utilization and evaluation of healthcare security among the elderly population in Beijing and analyzes the influencing factors to provide decision-making basis for improving the healthcare insurance system and achieving healthy ageing. Methods: A questionnaire survey of elderly people attending six different levels of medical institutions in Beijing was conducted to obtain information on elderly people's participation in basic medical insurance, use of basic medical insurance, hospital visiting, and evaluation of satisfaction with medical insurance and analyze the influencing factors of satisfaction using chi-square test and multi-factor logistic regression. Results: The participation rate and utilization rate were high among the elderly people being investigated, who preferred the manual payment in terms of reimbursement methods. The compliance rate of employees' medical insurance for the elderly in the vicinity of medical treatment was low. Many old people were very dissatisfied with or did not know about the reimbursement of medical insurance in a different pooling district. The health status, employees' medical insurance and urban and rural residents' medical insurance can significantly influence the elderly's satisfaction with medical insurance services in Beijing. Conclusion: It is recommended to further increase the participation rate and utilization rate of medical insurance for the elderly, to promote the graded diagnosis and treatment and supporting medical insurance system, to give full play to the policy overlap effect, to promote the rational allocation and utilization of medical resources, to continue to popularize and improve the medical insurance system for medical treatment in different places, to improve the benefits of urban and rural residents' medical insurance, to promote the integration of employees' medical insurance and urban and rural residents' medical insurance, and to finally promote the high-quality development of medical insurance and achieve healthy ageing.