Simulation analysis of medical insurance cost for urban residents in Kunming, China / 第二军医大学学报

ABSTRACT

Objective: To predict the medical expenses and distribution of different medical payments of urban residents in Kunming, who are covered by the medical insurance scheme. Methods: We created a static micro-simulation model for predicting and evaluating the 2008-2010 medical insurance scheme for urban residents of Kunming. The main datasets used for constructing the model included a 0.1% population sample dataset from the national census of 2000 and a dataset of urban employees and retirees under the social medical insurance scheme. Other data used in the model involved the aggregated results of 1% population survey of Kunming conducted in 2005. Results: Based on the population model of 2005, the population information and the data of employees and retirees covered by the social medical insurance scheme were integrated. The model provided information on resident incomes, medical expenses, medical expenses of outpatient services and severe illness; and the different kinds of payments could be forecasted by the model. Conclusion: Results of the present research can help the government in making relevant heath policies while ensuring the sustainable development of medical insurance scheme.