Research on Application of Big Data Technology in Cost Control of Medical Insurance For China

Tianxiao Chen
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Abstract

With the increasing aging of the population, medical insurance cost control has become a worldwide problem. In order to control the medical insurance fee, since 2009, China's medical insurance payment system has changed from the post payment system mainly based on projects to the prepayment system based on total amount control, but not only failed to control the growth of medical insurance expenditure, but also resulted in the phenomenon that the insured's right to medical treatment has been damaged. Using big data technology and other information-based means to fine manage medical insurance expenditure has become an urgent matter. The paper is divided into four parts. The first part introduces the characteristics of big data and the concept of big data technology; the second part, under the background of the reform of China's medical insurance payment system, analyzes the necessity and possibility of using big data technology to control medical insurance expenses; the third part, puts forward some measures of using big data technology to control medical insurance expenses; finally, the conclusion is drawn that the use of big data technology can realize the fine management of medical insurance control fee.
大数据技术在中国医疗保险成本控制中的应用研究
随着人口老龄化的加剧,医疗保险费用控制已成为一个世界性的问题。为了控制医保费用,自2009年以来,中国的医保支付制度由以项目为主的后付制度转变为以总量控制为主的预付费制度,不仅未能控制医保支出的增长,还造成了参保人就医权利受到损害的现象。利用大数据技术等信息化手段对医保费用进行精细化管理已成为当务之急。本文共分为四个部分。第一部分介绍了大数据的特点和大数据技术的概念;第二部分,在中国医疗保险支付制度改革的背景下,分析利用大数据技术控制医疗保险费用的必要性和可能性;第三部分,提出利用大数据技术控制医疗保险费用的若干措施;最后得出结论,利用大数据技术可以实现医保控制费的精细化管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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