Challenges and Reflections on Fund Management Posed by the Medical Behavior of Insured Individuals
Through analyzing the reasons why insured individuals' medical behavior poses challenges to the management of medical insurance fund, the following problems were found: significant differences in medical insurance benefits among different regions and insured identities, lack of information shar...
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| Format: | Article |
| Language: | zho |
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Editorial Office of Medicine and Philosophy
2025-02-01
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| Series: | Yixue yu zhexue |
| Subjects: | |
| Online Access: | https://yizhe.dmu.edu.cn/article/doi/10.12014/j.issn.1002-0772.2025.04.11 |
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| _version_ | 1849721384681340928 |
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| author | Huiyu HOU Huaxing ZHANG Jianbin WANG Jingtao LI Yiqing TIAN |
| author_facet | Huiyu HOU Huaxing ZHANG Jianbin WANG Jingtao LI Yiqing TIAN |
| author_sort | Huiyu HOU |
| collection | DOAJ |
| description | Through analyzing the reasons why insured individuals' medical behavior poses challenges to the management of medical insurance fund, the following problems were found: significant differences in medical insurance benefits among different regions and insured identities, lack of information sharing platforms across multiple departments and regions, insufficient regulatory capacity of the medical insurance fund, limited public awareness of medical insurance policies and fraudulent behavior, and the increasingly serious phenomenon of health anxiety. In response to the above reasons, the following measures are proposed: promoting provincial-level coordination of medical insurance, improving the management of medical insurance catalog, accelerating the digitalization of medical insurance, enhancing the supervision ability of medical insurance fund, strengthening the promotion of insurance policies, and alleviating public health anxiety. These measures aim to increase insured individuals' awareness of protecting the medical insurance fund and foster collaboration between insurance management departments and medical institutions to ensure the fund's sustainable development. |
| format | Article |
| id | doaj-art-a2df76fe7ca94b50b498c39410f7e73a |
| institution | DOAJ |
| issn | 1002-0772 |
| language | zho |
| publishDate | 2025-02-01 |
| publisher | Editorial Office of Medicine and Philosophy |
| record_format | Article |
| series | Yixue yu zhexue |
| spelling | doaj-art-a2df76fe7ca94b50b498c39410f7e73a2025-08-20T03:11:40ZzhoEditorial Office of Medicine and PhilosophyYixue yu zhexue1002-07722025-02-01464565910.12014/j.issn.1002-0772.2025.04.114-houhuiyuChallenges and Reflections on Fund Management Posed by the Medical Behavior of Insured IndividualsHuiyu HOU0Huaxing ZHANG1Jianbin WANG2Jingtao LI3Yiqing TIAN4Medical Insurance Management Office, Hebei General Hospital, Shijiazhuang 050051, ChinaMedical Insurance Management Office, Hebei General Hospital, Shijiazhuang 050051, ChinaMedical Insurance Management Office, Hebei General Hospital, Shijiazhuang 050051, ChinaMedical Insurance Management Office, Hebei General Hospital, Shijiazhuang 050051, ChinaMedical Insurance Management Office, Hebei General Hospital, Shijiazhuang 050051, ChinaThrough analyzing the reasons why insured individuals' medical behavior poses challenges to the management of medical insurance fund, the following problems were found: significant differences in medical insurance benefits among different regions and insured identities, lack of information sharing platforms across multiple departments and regions, insufficient regulatory capacity of the medical insurance fund, limited public awareness of medical insurance policies and fraudulent behavior, and the increasingly serious phenomenon of health anxiety. In response to the above reasons, the following measures are proposed: promoting provincial-level coordination of medical insurance, improving the management of medical insurance catalog, accelerating the digitalization of medical insurance, enhancing the supervision ability of medical insurance fund, strengthening the promotion of insurance policies, and alleviating public health anxiety. These measures aim to increase insured individuals' awareness of protecting the medical insurance fund and foster collaboration between insurance management departments and medical institutions to ensure the fund's sustainable development.https://yizhe.dmu.edu.cn/article/doi/10.12014/j.issn.1002-0772.2025.04.11insured individualsmedical behaviormanagement of medical insurance fundinsurance fraud |
| spellingShingle | Huiyu HOU Huaxing ZHANG Jianbin WANG Jingtao LI Yiqing TIAN Challenges and Reflections on Fund Management Posed by the Medical Behavior of Insured Individuals Yixue yu zhexue insured individuals medical behavior management of medical insurance fund insurance fraud |
| title | Challenges and Reflections on Fund Management Posed by the Medical Behavior of Insured Individuals |
| title_full | Challenges and Reflections on Fund Management Posed by the Medical Behavior of Insured Individuals |
| title_fullStr | Challenges and Reflections on Fund Management Posed by the Medical Behavior of Insured Individuals |
| title_full_unstemmed | Challenges and Reflections on Fund Management Posed by the Medical Behavior of Insured Individuals |
| title_short | Challenges and Reflections on Fund Management Posed by the Medical Behavior of Insured Individuals |
| title_sort | challenges and reflections on fund management posed by the medical behavior of insured individuals |
| topic | insured individuals medical behavior management of medical insurance fund insurance fraud |
| url | https://yizhe.dmu.edu.cn/article/doi/10.12014/j.issn.1002-0772.2025.04.11 |
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