基于数据仓库技术的医疗保险基金风险管理模型及其实现

自《国务院关于建立城镇职工基本医疗保险制度的决定》（国发1998]44号）发布以来,全国各地相继建立了以个人账户和统筹基金账户相结合的新的医疗保险制度。截止到2004年底,参加医疗保险个人达到12386万人,收缴医疗保险基金1000亿元,支出800多亿元。要使如此巨大的医疗保险基金充分地发挥社会保险的保障功能,对于基金的风险管理至关重要。本文介绍了采用数据仓库技术建立医疗保险基金风险分析系统的模型和软件的实现方法。并介绍了该系统的具体应用。

Model and realization of risk management for medical insurance based on data warehouse

Since state had issued "decision on establishing for employee basic medical insurances system for Urban Enterprise Employees"(national files1998]NO.44),New medical insurances has been established based on the model of combining social pooling with individual accounts. By the end of 2004, the total number of participating the basic medical insurance reached to more than 12386 ten thousands active workers, Income medical insurance fund was 1000 hundreds million,and providing medical insurance benefits with various length to 800 hundreds million. In order to prevent risk of medical insurance fund, Design method for Model and Realization of risk management for medical insurance based on data warehouse ,and application.