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目的针对城镇居民医疗保险体系,预测参保居民的医疗费用和各方费用分担分布。方法通过构建微观模拟模型,预测和评估2008~2010年昆明市城镇居民医疗保险政策。构建模型的数据包括2000年国家人口普查的0.1%样本数据,城镇职工医疗保险体系下的参保数据,其他数据信息包括昆明市2005年国家1%人口调查的结果。结果在2005年人口模型的基础上,实现人口信息数据和参保职工信息数据的统计拼接。获得个体收入和医疗消费信息,居民门诊大病和住院医疗的费用分布,预测不同途径的缴费水平。结论分析结果有助于政府在制订相关医疗保险政策时,考虑医疗保险政策的可持续发展。
Aim To aim at the medical insurance system of urban residents, predict the medical expenses and the distribution of the expenses of all parties participating in the insurance. Methods The micro-simulation model was constructed to predict and evaluate the medical insurance policy of urban residents in Kunming from 2008 to 2010. The data for building the model include the 0.1% sample data of the 2000 national census and the data of insured persons under the urban employee health insurance system. Other data and information include the results of the 1% national census of Kunming in 2005. Results Based on the population model in 2005, statistical statistics of population information data and insured worker information data were implemented. Access to individual income and medical spending information, resident outpatient illness and hospital medical expenses distribution, forecasting different levels of payment. Conclusion The results of the analysis help the government to consider the sustainable development of the medical insurance policy when formulating the relevant medical insurance policy.