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商业医疗保险损失分析:基于广义线性模型的实证研究
引用本文:仇春涓,陈滔.商业医疗保险损失分析:基于广义线性模型的实证研究[J].应用概率统计,2012,28(4):389-399.
作者姓名:仇春涓  陈滔
作者单位:1. 华东师范大学金融与统计学院,上海,200241
2. 西南财经大学保险学院,成都,611130
基金项目:西南财经大学211工程三期建设项目资助
摘    要:本文使用广义线性模型对商业医疗保险损失进行建模,并用某商业保险公司的医疗保险赔付数据进行了实证检验,结果表明,在影响医疗保险损失的诸多因素中,住院天数、医院级别、地区、保障档次等都是显著的因素,而性别和小于60岁以下年龄段内年龄则并不是显著因素,这些结论给医疗保险的经营和风险控制带来实际的意义.

关 键 词:医疗保险  广义线性模型  损失分析

Risk Factors of Losses of Commercial Medical Insurance:An Empirical Analysis Using Generalized Linear Models
Qiu ChunjuanSchool of Finance and Statistics,East China Normal University,Shanghai,Chen Tao.Risk Factors of Losses of Commercial Medical Insurance:An Empirical Analysis Using Generalized Linear Models[J].Chinese Journal of Applied Probability and Statisties,2012,28(4):389-399.
Authors:Qiu ChunjuanSchool of Finance and Statistics  East China Normal University  Shanghai  Chen Tao
Institution:School of Finance and Statistics, East China Normal University, School of Insurance, Southwestern University of Finance and Economics
Abstract:The risk factors of commercial medical insurance losses are investigated in this paper. We conduct an empirical analysis by fitting the Gamma generalized linear model to a commercial medical insurance's claims data. The result indicates that among the many candidate risk factors of medical insurance losses, the days of hospital stay, the hospital levels, the area where the insurance business is applied and the insurance level are significant. On the contrary, the gender and age are insignificant. Finally, some suggestions are presented, which we believe to be helpful for future medical insurance's operations and management.
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