农村大病医疗保险方案中就医经济风险测量(Ⅰ)

The Measurement of Economic Risk for Medical Service in Rural Area (I)

综合运用保险学、流行病学和系统论等理论和方法,通过对就医人群风险概率和风险损失额分析,研制出农村居民就医经济风险测量方法,建立了一套有关就医经济风险测量指标体系。该方法可用于分析农村居民就医经济风险,并且可以为医疗保险方案提供补偿比和费率计算提供实际数据。运用调查人群的数据进行的拟合,显示该技术具有科学性和可操作性,并据此提出实际操作关键步骤和注意要点。

Economic Risk for Medical Service (ERMS) is the probability of persons' paying huge cost to cure diseases in a period. Using the theory of insurance, epidemilolgy, and systematics, the research analyzed the probability and the economic loss of crowd' s going to doctors, therefore developed the methods of measuring ERMS in rural areas and index system of ERMS. The methods can be used to analyze ERMS and calculate the rate of insurance. After testified by the data of the surveying crowds, it is showed that the methods are scientific and operable in rural area. The research also suggest the key steps and some places needing more attentions in operation.