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    Title: 重大傷病醫療費用之推估
    Other Titles: Pricing for the Medical Expense of Critical Illness
    Authors: 黃泓智
    Contributors: 國立政治大學風險管理與保險學系
    行政院國家科學委員會
    Keywords: 重大傷病醫療費用;推估
    重大傷病;推估;人口變動要素合成方法;全民健保;敏感度分析
    Critical illness;medical expense estimate;burden of disease
    Date: 2003
    Issue Date: 2012-10-22 15:43:08 (UTC+8)
    Abstract: 近年台灣地區民眾的平均壽命因醫療進步及環境改善等因素而大幅延長,主要死因轉變為中老年疾病或是慢性病,需要長期追蹤、治療,衍生的醫療費用也將隨人口老化而逐步上升,未來極有可能對我國全民健康保險的財務自主產生重大影響。本文主旨在於探討人口老化對重大傷病的影響,包括重大傷病患病人數及醫療費用的推估,並討論推估結果代表的意義。本文資料分析以全民健康保險重大傷病資料庫(1996 年至2001 年)為依據,使用精算原則估計重大傷病門診醫療金額(例如:每人平均就診次數、平均每次就診金額、罹患重大傷病機率),再配合內政部的人口資料與人口變動要素合成(Cohort Component)方法,推估未來重大傷病門診醫療費用。研究發現重大傷病的門診醫療費用將隨時間直線上升,與我國人口老化的趨勢頗為一致,醫療費用的上升必對我國全民健康保險的財務造成重大影響;另外,本文亦計算個人在一定期間之重大傷病收支平衡年繳保費,此部份除了可以應用在實支實付型的商業保險外,也可以應用於評估健保政策為一定期間不調整保費時,為維持其財務收支平衡之應收總保費。
    The health care demand becomes larger and larger in the aging society result from the improvement of mortality and the geriatric and chronic diseases become major dead causes now. Under this circumstance, we aim to evaluate the future health care demand and the burden of disease in Taiwan by using critical illness and injury data among National Health Insurance database. In this research, we evaluate the future health care demand amount and outpatient expenditure per capita in Taiwan in actuarial way and evaluate the burden of disease by calculating the year lost due to disease and health life expectancy. According to research result, we argue that the demand of health care is increasing in almost linear way and the increase of health care cost becomes the important challenge to commercial health insurance.
    Relation: 應用研究
    學術補助
    研究期間:9208 ~ 9307
    研究經費:266仟元
    Data Type: report
    Appears in Collections:[風險管理與保險學系] 國科會研究計畫

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