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在风险调整系统中实施社会经济变量:以德国为例进行定量分析
Gerald Lux1, Theresa Hüer2, Florian Buchner3
1EsFoMed, Essener Forschungsinstitut für Medizinmanagement GmbH, Bredeneyer Straße 2b, Essen D-45133, Germany; FOM University of Applied Sciences, Leimkugelstraße 6, Essen D-45141, Germany.
Health policy (Amsterdam, Netherlands)
|November 12, 2024
概括
德国的社会医疗保险制度不足以为社会经济弱势群体提供资金. 本研究探讨了风险调整的修改,以更好地补偿这些人,揭示了模型实施中的权衡.
科学领域:
- 卫生经济学 卫生经济学
- 社会保险政策 社会保险政策
- 公共卫生 公共卫生
背景情况:
- 竞争性社会医疗保险系统使用基于发病率的风险调整来实现公平竞争.
- 目前的系统可能不足以为具有特定社会经济特征的个人提供资金,从而为风险选择创造激励.
- 德国正在讨论将社会经济变量纳入其风险均等化系统,以解决补偿不足问题.
研究的目的:
- 分析德国当前风险均等制度中四个社会经济群体的过低或过高补偿情况.
- 审查拟议的修改,以将社会经济变量纳入德国风险调整系统.
- 通过使用大型数据集来评估这些修改的性能.
主要方法:
- 对被保险人获得共同支付豁免,失业基本收入支持,社会长期护理保险福利和收入能力降低的补偿水平的分析.
- 对将这些社会经济变量纳入德国风险调整模型的几次尝试的评估.
- 使用大约920万保险人的数据集进行绩效评估.
主要成果:
- 该研究确定了在现有的德国风险均等制度下,针对特定社会经济群体的系统性过低或过高补偿.
- 纳入社会经济变量的修改显示了更好地适应弱势群体的潜力.
- 不同的模型产生不同的结果,突出了实现公平补偿的复杂性.
结论:
- 德国目前的风险均等制度不充分补偿某些社会经济不利的保险人群.
- 将社会经济变量纳入风险调整模型是必要的,以获得更公平的补偿.
- 仔细考虑权衡对于实施有效的风险调整模型至关重要,以减轻低补偿.
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