我国大病保险最优补偿分段方式与区间数量研究

我国大病保险补偿方案制定中,分段的方式以及区间的数量尤为重要.本文在区间等分、等比递增和等比递减三种分段方式下,分别建立以区间数量为自变量,以大病保险补偿额度为因变量的理论模型.以期望补偿比例作为衡量大病保险补偿水平的标准,在不低于95%的期望补偿比例下,理论结果显示:(i)区间等分、等比递增和等比递减三种分段方式对应的最佳区间数量分别为3个、3个和5个;(ii)在设定前述最优区间数量时,区间等比递增模式的补偿水平最高,其次为区间等比递减模式,区间等分模式的补偿水平最低,但是三者相差不大.接着,基于2015年的CHARLS数据为实证,计算三种区间分段方式下,家庭灾难性医疗支出发生率依次为7.13%、7.26%和7.69%,与理论的结果一致.

Study on the Number and Mode of Optimal Piecewise of Critical Illness Insurance in China

The modes of piecewise and the number of intervals are particularly important in the formulation of compensation scheme for critical illness insurance in China.In this paper,under the three subsection modes of interval bisection,constant ratio increment and constant ratio decrement,the theoretical models are established with interval quantity as independent variable and serious illness insurance compensation amount as dependent variable.Taking the expected compensation ratio as the standard to measure the compensation level of serious illness insurance,we can get the following results:first,the optimal number of intervals corresponding to the three interval modes are respectively:3,3 and 5;second,under the setting of the number of piecewise,the compensation level of the interval equal proportion increasing mode is the highest,the interval equal proportion decreasing mode is the second,and the compensation level of the interval equal proportion increasing mode is the lowest,But there is little difference between the three.Then,based on the data of CHARLS in 2015,we calculated the incidence of family catastrophic medical expenditure under the three interval modes as 7.13%,7.26%and 7.69%respectively.The result is consistent with that of the theory.