A Statistical Analysis Of Medical Insurance Data

Medical insurance is one of the five social insurances in our country.It plays an increasingly important role in promoting economic development,protecting public health and maintaining social stability.With the development of the medical insurance system,expanded coverage,and the increasing number of the insured and insurance funds,how to allocate the medical insurance funds scientifically and reasonably has become a crucial problem in the development.At present,there are a lot of studies domestic and aboard.Many classic and effective allocation schemes have been proposed,such as,the DRGs-PPS method of payment,fee for service,capitation,global budget and so on.The aim of this paper is to build a scientific and reasonable model for funds allocation,which is based on data and combined with the existing allocation methods.Medical insurance funds allocation process includes two parts.First,management institution allocates the funds to designated medical institutions.Secondly,the designated institutions allocate the funds to each department.With regard to this process,the paper consists of two parts to build models to analyze.In the first part,it analyzes a lot of data which contains 12 million medical records from 2008 to 2013.Then by analyzing and classifying the data,adding covariates,and applying ARIMA model,it predicts the 2014 medical insurance cost of every designated medical institutions.In the second part,we research the medical records of a typical hospital and build an evaluation model by using linear regression and analytic hierarchy process method to evaluate the performance of different departments.On account of the performance,we allocate the funds to departments.Finally,by comparing the predicted data with real data,the result shows that the prediction model of this paper is very accurate and reasonable.