| Objectives: Understand the current satisfaction of insured persons in a certain prefecture-level city in Gansu province towards the service quality of the staffs at the medical insurance agency window,and analyze the influencing factors of them;and explore the relationships between insured persons’ expectation level,satisfaction level,perceived quality,trust level,and complaint level towards staffs’ service.Based on this,provide reasonable suggestions for optimizing the service quality of the staffs at the medical insurance agency window in the prefecture-level city.Methods: This study conducted a self-administered questionnaire survey on insured persons who visited the service center of the medical insurance agency in a certain prefecture-level city in Gansu Province from March to May 2022.The questionnaire included basic information of the study subjects,the current status of service provided by the staffs at the medical insurance agency window,and a theoretical index model of the satisfaction of the insured persons(with 5 dimensions and 26indicators).Binary logistic regression was used to analyze the predictors influencing the satisfaction rate of insured persons of different insurance types,while ordinal multivariate logistic regression was used to analyze the predictors influencing the satisfaction level of insured persons of different insurance types.Multiple linear regression was used to analyze the influence of demographic variables on the theoretical index model of insured persons’ satisfaction level in each dimension.Using AMOS 26.0to construct the antecedent latent variable model that influences the satisfaction level of insured persons and the mediating effect model of the satisfaction level of insured persons between the perception quality,complaint level,and trust level of insured persons,the influence of antecedent latent variables(perceived quality and expected level)on the satisfaction level of insured persons and the mediating effect of the satisfaction level of insured persons were analyzed through path analysis.Results:(1)A total of 551 valid questionnaires were collected in this study,of which 36.3% were males,27.2% were employed in enterprises,59.9% had a bachelor’s degree or above,85.1% were married,74.0% were urban employees,and 26.0% were urban and rural residents.(2)Satisfaction rate of urban employee insured persons and urban and rural resident insured persons and its influencing factorsThe satisfaction rate of 408 urban employee insured persons with the service of the staffs at the medical insurance agency window was 61.5%.Multivariate analysis showed that insured individuals who believed that the window staffs had a good understanding of medical insurance policies(a OR=2.27,95%CI: 1.30-3.94),a good service attitude(a OR=11.19,95%CI: 5.34-23.36),and higher work efficiency(a OR=11.44,95%CI: 6.32-20.71)were more likely to be satisfied with the services provided by the staffs at the window of the medical insurance agency compared to their respective control groups.The satisfaction rate of 143 urban and rural resident insured persons with the service of the staffs at the medical insurance agency window was 61.3%.Multivariate analysis results showed that insured persons who believed that the window staffs of medical insurance agency had good service attitudes(a OR=9.32,95%CI: 3.10-28.03)and higher efficiency(a OR=12.58,95%CI: 4.17-37.93)were more satisfied with window staffs than the control group.(3)Satisfaction level of urban employee insured persons and urban and rural resident insured persons as well as its influencing factorsAmong the 408 urban employee insured persons,24.3% were dissatisfied with the service of the staffs at the medical insurance agency window,58.1% felt generally satisfied,and 17.6% felt satisfied.Multivariate analysis results showed that the satisfaction level of males(a OR=1.76,95%CI: 1.15-2.70)was higher than that of females.The more the window staffs understood the medical insurance policy(a OR=1.72,95%CI: 1.15-2.57),the more proactive they were in their service(a OR=9.41,95%CI: 4.25-20.81),and the higher efficiency they handling affairs(a OR=2.56,95%CI: 1.60-4.10),the more satisfied the insured were with their service.Among the 143 urban and rural resident insured persons,16.8% were dissatisfied with the service of the staffs at the medical insurance agency window,61.5% felt generally satisfied,and 21.7% felt satisfied.Multivariate analysis results showed that compared to the control group,the insured had higher levels of satisfaction with the service when they did not need to queue repeatedly during the process of handling their business(a OR=0.41,95%CI: 0.18-0.93)and when the staffs at the medical insurance agency window had higher work efficiency(a OR=4.18,95%CI: 1.80-9.70).(4)Empirical study of the theoretical index model of insured persons’ satisfactionThe scores for insured persons’ satisfaction level,perceived quality,expected level,and trust level were 3.36±1.24,3.36±1.25,3.35±1.23,3.54±1.20,and 3.24±1.31,respectively.Multivariate analysis results showed that insured persons with a high school education(β=0.19,95%CI: 0.03-0.35)had a higher levels of satisfaction with the service of the medical insurance agency’s window staffs.Insured persons with a bachelor’s degree or above had higher levels of satisfaction(β=0.13,95%CI: 0.03-0.22),perceived quality(β=0.09,95%CI: 0.01-0.18),trust level(β=0.09,95%CI: 0.02-0.18),and lower levels of complaint(β=0.12,95%CI: 0.01-0.22)towards their service.The expected level and perceived quality of the service provided by the medical insurance agency’s window staffs positively influenced the satisfaction level of insured persons.The satisfaction level of insured persons played a partial mediating role in their perceived quality towards their trust level and complaint level.Conclusions:(1)The satisfaction rate of the service quality of the staffs at the medical insurance agency’s window was relatively low among urban employees and rural residents insured under the medical insurance scheme;(2)The service attitude,work efficiency,and understanding of medical insurance policies of the window staffs in medical insurance agencies all had an influence on the satisfaction of urban employee and urban-rural resident insured persons;(3)The expected level and perceived quality of service of insured persons have a positive impact on their satisfaction level.Perceived quality of service is an important factor that influences insured persons’ trust and complaint level,which can be mediated by their satisfaction level.This suggested that training for window staffs in medical insurance agencies should be strengthened to improve their understanding of medical insurance policies.And performance evaluation mechanisms should be established to supervise and evaluate their services,constrain their bad service behaviors,and improve their service attitude.The introduction and implementation of a comprehensive teller system should also be actively pursued to achieve service standardization among all window staffs,thereby improve the efficiency of business processing to enhance service quality and increase insured persons’ satisfaction. |
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