Risk estimation based on mixed normal distribution model for diabetes-related hospitalization claims

摘要

Medical insurance service, the important part of national healthcare supporting system with a history dating back more than 100 years ago, remains a global challenge because of its high rates of compensation and difficulty in risk control. When developing the diabetes related, hospitalization insurance, we found that the risk loss of the diabetic inpatients does not follow a symmetrical unimodal distribution: in fact, it is hard to describe its risk loses distribution with a single probability distribution model. Therefore, we put forward a risk measurement method based on a mixed normal distributions model for medical insurance of inpatients with diabetes.