摘要
本文使用广义线性模型对商业医疗保险损失进行建模,并用某商业保险公司的医疗保险赔付数据进行了实证检验,结果表明,在影响医疗保险损失的诸多因素中,住院天数、医院级别、地区、保障档次等都是显著的因素,而性别和小于60岁以下年龄段内年龄则并不是显著因素,这些结论给医疗保险的经营和风险控制带来实际的意义.
The risk factors of commercial medical insurance losses axe investigated in this paper. We conduct an empirical analysis by fitting the Gamma generalized linear model to a commercial medical insurance＇s claims data. The result indicates that among the many candidate risk factors of medical insurance losses, the days of hospital stay, the hospital levels, the area where the insurance business is applied and the insurance level axe significant. On the contrary, the gender and age are insignificant. Finally, some suggestions are presented, which we believe to be helpful for future medical insurance＇s operations and management.
出处
《应用概率统计》
CSCD
北大核心
2012年第4期389-399,共11页
Chinese Journal of Applied Probability and Statistics
基金
西南财经大学211工程三期建设项目资助
关键词
医疗保险
广义线性模型
损失分析.
Medical insurance, generalized linear model, loss analysis.
