Analysis On The Prediction Of Revenue And Expenditure Of Xi'an Medical Insurance Unified Funds

Health insurance is a worldwide problem. The key of whether medical insurancesystem can develop sustainably and healthily or not is the insurance fundcollection-payment balance, because many countries'social medical insurancetreatment can not be sustainable because of disequilibrium of balance and enormousfinancial deficit. Therefore, we must consider about the effect of various factorscomprehensively, further research to and perform quantitative data calculations on thecost of medical expenses and then comprehensive analyze and predict of medicalinsurance fund loss. This is the priority of the guarantee fund balance. Based on theRisk Theory, Loss Distribution Theory and the Bayesian Prediction Theory, thisresearch focuses on the social medical insurance actuarial, analyzing the factor ofdisease within the various factors which influence the expenses of medical insurancefund, to establish the risk loss prediction model based on the disease types and comparewith the conventional linear regression model, whose final aim is to establish themethods of controlling medical insurance cost, grasp the control degree, and provide thereference for the adjustment to medical insurance's raising finance and the level oftreatment.The main job of this paper can be concluded as follows:Firstly, through an overall review of relevant literatures, this paper builds an riskloss insurance actuarial model based on the diseases, and puts forward the parameters ofthe model, the method of acquiring parameters or forecasting parameters' data, and thenmake an empirical analysis on the 2634 sample data of hospitalized patient recordsusing the statistical software SPSS17.0 to predict the funds' expenditure values.Secondly, build and test the multivariate linear regression models of the fund'income and expenditure based on the historical data of fund' income and expenditureand its influencing factors using SPSS17.0 and Excel, and then predict the fund incomeand expenditure values for the next five years according to this model.Thirdly, by comparing the two models, this paper analyses the social applicabilityand the advantage and disadvantage of the risk loss prediction model. The empiricalresults indicate that the risk loss prediction model based on the diseases is not onlybetter than the multivariate linear regression model in the rationality of details onpredicting, and it can strengthen the control dynamics of insurance compensation, but also takes more influence factors of forming fund's expenditure into consideration thanthe multivariate linear regression model.Finally, on the base of the empirical researches, this paper presents flexibleapplications of the risk loss prediction model on several aspects, and provides new ideasand methods to achieve specific researches on various factors affecting the expenses ofmedical insurance fund. Then based on the limitations of the empirical study, this paperemphasizes the importance of establishing the electronic medical records and medicalinformation system, which can offer the solution to this study's limitations, and thenexpects the information system of electronic medical records to establish as soon aspossible, to play an important role in the digitization and scientific of the hospitalmanagement, fund's spending management and etc.