DOI: 10.14704/nq.2018.16.5.1402

Coupled and Coordinated Development of Medical and Commercial Insurances Based on Cognitive and Behavioral Science

Xusheng Zhang, Fei Mi, Libin Zeng, Xiaosheng Yang, Hailan Liu, Junhui Xiao


The development of China’s commercial insurance and social medical insurance in recent years is aimed to analyze the comprehensive evaluation indicators, coupling and coordination factors of two underwriting types after counting up a number of indices such as China’s underwriting premium income and expenditure, loss ration, medical underwriting premium income as a percentage of China’s gross health revenue and its composition, etc. 20 residents who have purchased commercial and medical insurances were random chosen as subjects. Based on the theory of cognitive and behavioral science, we analyze comprehensive evaluation indicators, coupling property, and coordination of the two underwriting types. According to our findings, the comprehensive development level of these two insurances were on the rise in 2005~2015, and their coupling and coordination factors also showed year-by-year growth trend but at a low level. They gradually hiked up to moderate extent after 2011. There are significant gaps among above three indices in the east, central and west China. As for commercial insurance, the coverage in the central and west China grows dramatically, while the market in the east China has been nearly saturated since 2011; as for social medical insurance, the comprehensive evaluation indicators in the east China remain at a higher level than that in the central and west China, but there are no more obvious gaps between them. The coupling and coordination factors in the east China are relatively high and have reached moderately coupled and coordinated levels, but roughly coincide with each other at a low level in the central and west China.


Medical insurance; commercial insurance; data mining; coupling; coordination

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Baker JJ. Medicare payment system for hospital inpatients: diagnosis-related groups. Journal of Health Care Finance 2002; 28(3): 1-13.

Blomqvist Å, Johansson PO. Economic efficiency and mixed public/private insurance. Sse/efi Working Paper 1997; 66(3): 505-16.

Bowen SE. Evaluating outcomes of care and targeting quality improvement using medicare health outcomes survey data. Journal of Ambulatory Care Management 2012; 35(4): 260-62.

Carrin G, Mathauer I, Xu K, Evans DB. Universal coverage of health services: tailoring its implementation. Bulletin of the World Health Organization 2008; 86(11): 857-63.

Chan ALF, Cham TM, Lin SJ. Direct medical costs in patients with alzheimer's disease in taiwan: a population-based study. Current Therapeutic Research 2009; 70(1): 10-15.

Chen CT. Extensions of the topsis for group decision-making under fuzzy environment. Fuzzy Sets & Systems 2000; 114(1): 1-9.

Chiu HC, Shi HY, Mau LW, Wang GJ. The effects of a prospective case payment system on hospital charges for total hip arthroplasty in taiwan. Journal of Arthroplasty 2007; 22(1): 65-71.

Chodick G, Porath A, Alapi H, Sella T, Flash S, Wood F, Shalev V. The direct medical cost of cardiovascular diseases, hypertension, diabetes, cancer, pregnancy and female infertility in a large hmo in israel.Health Policy 2010; 95(2-3): 271-78.

Cots F, Mercadé L, Castells X, Salvador X. Relationship between hospital structural level and length of stay outliers. Health Policy 2004; 68(2): 159-70.

Eastaugh SR. Viewpoint: national healthcare spending and fiscal control: comparisons among 15 countries. Hospital Topics 2000; 78(4): 9-13.

Ellis RP, Mcguire TG. Supply-side and demand-side cost sharing in health care. Journal of Economic Perspectives A Journal of the American Economic Association 1993; 7(4): 135-143.

Frenk J, Sepúlveda J, Gómez-Dantés O, Knaul F. Evidence-based health policy: three generations of reform in mexico.Lancet 2003; 362(9396): 1667-73.

Frenk, J. Reinventing primary health care: the need for systems integration. Lancet 2009; 374(9684): 170-73.

Grembowski DE, Cook KS, Patrick DL, Roussel AE. Managed care and the us health care system a social exchange perspective. Social Science & Medicine 2002; 54(8): 1167-80.

Gress S, Niebuhr D, Rothgang H, Wasem J. Criteria and procedures for determining benefit packages in health care: a comparative perspective. Health Policy 2005; 73(1): 78-91.

Guariglia A, Rossi M. Private medical insurance and saving: evidence from the british household panel survey. Journal of Health Economics 2004; 23(4): 761-83.

Knaul FM, Frenk J. Health insurance in mexico: achieving universal coverage through structural reform. Health Affairs 2005; 24(6): 1467-76.

Liu GG, Zhao Z, Cai R, Yamada T, Yamada T. Equity in health care access to: assessing the urban health insurance reform in china. Social Science & Medicine 2002; 55(10): 1779-94.

Liu H, Gao S, Rizzo JA. The expansion of public health insurance and the demand for private health insurance in rural china. China Economic Review 2011; 22(1): 28-41.

Schut FT, Hassink WH. Managed competition and consumer price sensitivity in social health insurance. Journal of Health Economics 2002; 21(6): 1009-29.

Tamm M, Tauchmann H, Wasem J, Gress S. Elasticities of market shares and social health insurance choice in germany: a dynamic panel data approach. Health Economics 2007; 16(3): 243-56.

Waters HR, Hussey P. Pricing health services for purchasers--a review of methods and experiences. Health Policy 2004; 70(2): 175-84.

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