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目的 为铁道部制定医保全面实施方案提供重要的科学依据。方法 采用配对比较研究、多元逐步回归分析及统计预测等方法。结果 调查分析了铁路医保试点地区医保前后，医疗工作的数量、质量、效率及医疗费用，寻找出职工个体方面对医疗费用的主要影响因素，并对医疗费用进行统计预测。结论 医保后，医疗工作的质量、效率、职工医疗保障水平明显提高；医疗费用的增长幅度得以有力的遏制；职工个体方面对医疗费用的主要影响因素是年龄、工作状态、工作类别、体育锻炼、吸烟、酗酒、饮食卫生等；对医保试行方案提出了重要的修改意见。
Objective To provide an important scientific basis for the Ministry of Railways to formulate a comprehensive implementation plan for medical insurance. Methods Paired comparative studies, multiple stepwise regression analysis, and statistical prediction were used. Results The investigation analyzed the quantity, quality, efficiency and medical expenses of medical work before and after the medical insurance in the pilot areas of railway medical insurance, and searched for the main influencing factors of medical expenses for individual employees, and made statistical forecast of medical expenses. Conclusion After medical insurance, the quality and efficiency of medical work and the level of medical insurance for employees are significantly increased; the growth rate of medical expenses can be effectively curbed; the main influencing factors on medical expenses for individual employees are age, work status, job type, physical exercise, Smoking, alcohol, food hygiene, etc.; proposed important amendments to the Medicare pilot program.