Method and system for quantifying influence of basic medical insurance policy adjustment on fund expenditure

Abstract

The invention discloses a method and a system for quantifying the influence of basic medical insurance policy adjustment on fund expenditure. The method comprises the following steps of collecting samples: collecting basic medical insurance reimbursement detail data and basic medical insurance policies of all insured persons in the recent medical insurance year wherein the basic medical insurancepolicies comprise the original basic medical insurance policies and the new basic medical insurance policies corresponding to the medical insurance year; counting data: counting the accumulated basicmedical insurance reimbursement amount of all insured people in the medical insurance year based on the original basic medical insurance policy; and carrying out modeling prediction: calculating the basic medical insurance reimbursement amount and the policy influence factor of all insured people of the medical insurance year based on the accumulated new policy under the new basic medical insurance policy so as to predict the basic medical insurance reimbursement amount under the new policy in the future.

Description

technical field [0001] The present invention relates to the technical field of basic medical insurance policy adjustment, in particular to a method and system for quantifying the influence of basic medical insurance policy adjustment on fund expenditure. Background technique [0002] With the establishment of the Medical Insurance Bureau and the continuous progress of medical reform, new basic medical insurance policies are frequently introduced, and the new policies have a huge impact on medical expenses. At the same time, the aging of the population and the continuous growth of per capita disposable income have led to an increase in medical expenses year by year, which puts great pressure on the sustainable operation of the medical insurance fund. By simulating the impact of medical insurance policies on the pooling fund and the amount of critical illness compensation under various scenarios, the adjustment of medical insurance policies is quantified, and the impact factor...

AI Technical Summary

Problems solved by technology

[0003] Due to the complexity of medical insurance policies, ordinary calculation methods can only be estimated on an overall level, and it is difficult to accurately calculate the impact of medical insurance policy adjustments on medical insurance funds

Images