Open AccessImpact of basic medical insurance fund risk on the health risk assessment of urban residents
Author(s) -
Jianyu Jia,
Li Song,
Lin Li
Publication year - 2021
Publication title -
work
Language(s) - English
Resource type - Journals
eISSN - 1875-9270
pISSN - 1051-9815
DOI - 10.3233/wor-205352
Subject(s) - business , actuarial science , medical underwriting , delphi method , work (physics) , medical insurance , finance , insurance policy , income protection insurance , general insurance , computer science , mechanical engineering , artificial intelligence , engineering
BACKGROUND: The key to smooth running of medical insurance lies in whether the medical insurance fund can meet the needs of people’s medical and health services while achieving a balance between income and expenditure. However, the current impacts of various factors make the risk of medical insurance fund more and more prominent. OBJECTIVE: This investigation is to explore the impacts of basic medical insurance fund on the health of urban residents. METHODS: The corresponding risk evaluation index system is obtained from the structure, operation process, and operation results of the medical insurance fund. The health risks of local residents are evaluated based on the Delphi method. RESULTS: The analysis of the influencing factors reveals that the risk of medical insurance fund is significantly correlated with the medical health of urban residents. From 2016 to 2019, the overall risk assessment for health insurance funds of the whole city is around 82 score. CONCLUSION: The risk assessment system proposed can effectively assess the risks of the medical insurance fund for urban residents. This work provides an important reference for risk prevention and control of medical insurance fund management departments.