时间序列模型在医保总额管理中的运用及效果评价  

Evaluating the Effect of Application of Time Series Model in the Management of Total Medical Insurance

作　　者：张杰辉[1] 暨宜彰[1] 王冬[2] 熊美凤[1] 郭煜[1] 

机构地区：[1]南方医科大学南方医院,广东广州510515 [2]南方医科大学卫生管理学院

出　　处：《中国卫生事业管理》2017年第4期261-263,共3页Chinese Health Service Management

基　　金：广东省高校哲学社科重点实验室项目"公共卫生政策研究与评价重点实验室"(编号:2015WSYS0010)

摘　　要：目的:探讨时间序列模型在预测医保总额中的可行性。方法:以某医院2010年~2014年发生的D市参保人实际医保记账费用数据为基础,对D市下达总额控制数据资料进行追踪研究,发现其周期性变化规律,运用SPSS19.0专家建模器建立时间序列模型,对2015年某医院发生记账费用进行预测,并用实际发生记账费用进行验证。结果:研究表明,时间序列模型测算的预测拟合值与观测值总体相差3.37%,与实际情况基本吻合。结论:时间序列模型能为医院在医保总额控制管理中的决策与应用提供参考依据。Objective To explore the feasibility of time series model in predicting the total medical insurance. Methods Based on the data of insured medical insurance accounting cost in one city from 2010 to 2014, the total amount data was followed - up studied to explore its change rule. Time series model was established by using SPSS 19.0 expert modeler to predict the accounting cost in 2015, which was verified with actual cost accounting. Results The difference between predicted fitting value and observed value was 3.37% , which was nearly consistent with the actual situation. Conclusion Time series model can provide references for the decision and application in the control and management of medical insurance.

关 键 词：时间序列 医保 总额 预测模型 

分 类 号：F842.684[经济管理—保险] R197.1[医药卫生—卫生事业管理]