居民可承受商业健康保险市场空间与覆盖领域——基于四川数据的案例分析  

Researches on The Market Space and Coverage Fields of Residents'Affordable Commercial Health Insurance

作　　者：刘莉 郑小华 张岚 胡锦梁[3] 黄薇 白红 Liu Li(Sichuan Academy of Social Sciences,Chengdu,P.R.China)

机构地区：[1]四川省社会科学院,四川成都610000 [2]四川天府健康产业研究院 [3]四川省医学科学院·四川省人民医院

出　　处：《中国卫生事业管理》2021年第4期273-276,309,共5页Chinese Health Service Management

基　　金：四川省科技计划项目(软科学项目)(2020JDR0282)。

摘　　要：目的:通过对基本医疗的理论界定确定基本医疗保险和商业医疗保险覆盖范围,通过测算可承受的医疗费用标准,估算四川省可承受的商业保险费用总额方法:居民经济承受能力与医疗负担均衡模型,y_(1)=a_(2)+b_(1)/(x+c_(1)),y_(2)=a_(2)-b_(2)/(x+c_(2)),居民商业健康保险费用空间估算模型。结果:基本医疗卫生服务和非基本医疗服务界定可由居民经济承受能力,需求层次和技术的适宜性等属性区分;四川省有63%的人群具有购买商业保险的能力,可能具有的市场空间为1810亿元结论:相对现有百亿级的商业健康保险市场,四川省商业健康保险市场空间巨大,拓展这一市场的策略是做好特需服务领域和高新技术服务领域的保险产品设计。Objective To determine the coverage of basic medical insurance and commercial medical insurance,and estimate the total amount of commercial insurance expenses that can be borne by Sichuan Province.Methods Residents'economic affordability and medical burden balance model,and residents'commercial health insurance cost space estimation model were used.Results The definition of basic and non-basic medical services can be distinguished by attributes such as residents'affordability,level of demand and technological suitability.56%of the population in Sichuan Province has the ability to purchase commercial insurance.And the possible market space is 181 billion RMB Yuan.Conclusion Compared with the existing tens of billions of commercial health insurance market,there has a huge market of commercial health insurance in Sichuan Province.The strategy for expanding this market is to design insurance products in areas of special services and high-tech services.

关 键 词：商业健康保险 居民经济可承受 市场空间 覆盖领域 

分 类 号：R197[医药卫生—卫生事业管理] F84[医药卫生—公共卫生与预防医学]