The rapid development of the economy and society、Population aging continues to intensify、Disease mode changes and the widely used medical technology technology，The rapid increase in medical expenditures in various countries，How to use limited medical resources to maximize the level of health level becomes a hot spot and difficulty in the well -being related to all human beings。From developed countries to China，An important policy to respond to rising medical expenditures，It is a medical insurance payment method from paying from service items to the first payment、Prepaid methods such as paid such as the diagnosis of disease diagnosis。

Under the prepaid method，According to age、Gender and other population characteristics. Prediction of medical expenses in advance is very important，This directly affects the determination of the prepaid quota。There are two important problems in the process of modeling。First is the concentration of medical expenditure。The proportion of high medical consumer population and the proportion of medical expenditure，High medical expenditure although the proportion of the incurred is not high，But the cost of total cost is very high。such as，1%of the insured people spend 50%of the general medical expenditure。Second, the continuity of medical expenditure。Medical expenditure Once it occurs, it is likely to last for a long time，In this case，Whether the medical expenditure of the whole society can meet relevant medical needs for a long time，Whether there is sufficient system and capital guarantee。How to implement disease bet365 Play online games management for this part of high expenditure group and persistent characteristics，Developing a special major illness insurance policy is an important focus of public policy analysis。

　　bet365 live casino games

Medical expenditure concentration，Studies on the concentration of medical expenditure in developed countries and regions have found that medical expenditure is highly distributed，A small part of the group consumes most medical resources。such as，The proportion of medical expenditures of 5%of the group in the United States from 1996 to 2012 accounted for about 50%of the total expenditure。France in 2008 and 2013 10%of group expenditure accounted for 59%and 62%, respectively.。

In terms of continuity of medical expenditure，European and American developed countries and regions have successively established a medical insurance system covering the whole people after World War II，Its goal is to provide funding for residents' medical needs。With medical technology progress、Income increase、Population aging and disease spectrum transformation，Medical expenditure began to rise，The corresponding expenditure risk is also rising。Starting from the end of the 20th century，In developed countries and regions, from strict supervision fees to the use of market mechanisms to establish incentive compatibility fees，It has aroused further attention of researchers' sustainability of medical expenditure。Since the 21st century，Studies on the continuous medical expenditure research began to pay attention to disease and health management。Research on empirical analysis of people under the age of 65 in the United States，Medical expenditure has strong sustainability and concentration，The highest 10%expenditure group will still have a probability of 34.4%in Bet365 app download 5 years.，and many symptoms of diseases still exist after 5 years。

　　Chinese medical expenditure concentration and continuity coexist

Experience based on developed countries has confirmed the existence of concentration and persistence of medical expenditure。China is the world's largest developing country，The level of residents' income and medical security is not high，Is medical expenditure also concentrated and sustainable? I found out，Similar to developed countries，Nearly 50%of the medical expenditure in China is generated by the top 10%of the expenditure group，It means that the 1%insurance population spent about half of the medical expenditure。But，High medical expenditure groups are characterized by characteristics of developing countries。

First, the age distribution of the first 10%expenditure group is downtown U -shaped，Concentrated in people around 60 years old，The average medical expenses with adults in developed countries form a sharp contrast with age monotonous。During the sample period, the proportion of people over the age of 10%of the year of the year increased year by year，Show as income increases and the level of medical security increases，Graduation of medical needs for the elderly。

Second, the proportion of men in the top 10%of the group is higher than women，Disease types are chronic characteristics，But damage、Poisoning, etc. still account for a certain proportion，The transition of the disease spectrum is still in progress。When considering a longer time span，The concentration of medical expenditures has decreased，But the merger calculation display during the sample period，1%of the medical expenditure of the insurance group accounted for the total expenditure and the proportion of the total expenditure is still close to 30%，It indicates that medical expenditures have strong bet365 best casino games sustainability。Another，Payment expenditure analysis shows that the proportion of the first 1%of the insurance group's payment expenditure decreases over time，But the calculation ratio of the consolidation of the sample is still as high as 46.2%，It indicates that it is necessary and important for continuing to promote the insurance insurance and increase protection.。Analysis of the transfer matrix show，The probability of staying in the sequence after 1 year in the top 10%of the group is 37.6%; although the probability is decreased over time，But after 6 years, 26.1%may continue to cost high expenditure。

Third, the proportion of people over 65 years old in high -expenditure groups increased year by year，The New Year's Eve correlation of medical expenditure is also slowly increasing，It indicates that with the increase of residents' income and the level of medical security，China's sample region has a tendency to converge to developed countries in the concentration and persistence characteristics of medical expenditure。

Based on two models，The author further analyzes the differences in persistent characteristics of hospitalization probability and hospital medical expenditure level，and the effects of different disease types on the sustainability of medical expenditure。Estimation results indicate，Medical probability and the persistent characteristics of medical expenditure levels are different。Once hospitalized expenses，The probability of continuing hospitalization in 1 year will increase significantly by 6.9%，increased 5.2%after 2 years。Although the continuity is weakened over time，But the probability of hospitalization after 6 years still increases by 2.4%。In the case of a given medical expenditure，The continuity of the level of medical expenditure is more reflected in the two adjacent periods。The bet365 best casino games first phase of the expenditure increases for every 10%increase，The current expenditure will increase by 0.35%; the first two periods and earlier expenditure will increase by 10%，and the current expenditure increase is only 0.1%or lower。After controlling the characteristics of the disease and medical institution，65 years old and above do not show stronger expenditure sustainability。We speculate that the possible reason is that the health investment obtained by the elderly in rural areas in China，or the mortality rate of the elderly after the onset of the elderly。After adding the disease and medical institution variables，The sustainability of the expenditure of female medical expenditures exceeds men to a certain extent。

　　Further improve the risk protection of major diseases

The important reason for the concentration of medical expenditure is the small probability nature of major diseases and the aging population，The important reason for persistence is the transformation of the disease spectrum，That is, chronic and non -infectious diseases dominate。Another，Increased income and improvement of medical technology also played an important role。Modern diseases are chronic characteristics，The probability of some diseases is small but the cost is high，It may be an important reason for the concentration of medical expenditure。Analysis of the concentration of medical expenditure shows that the types of diseases of the top 10%of the expenditure group are serious and chronic characteristics。

The treatment cycle of chronic diseases is longer，Medical expenditure that is easy to cause persistence，and the onset group is mainly the elderly，aging will further lead to rising medical expenditures，The first 10%expenditure group is mainly about 60 years old。Increase increase in income、Payment ability is improved、Medical technology progress and treatment bet365 best casino games methods are richer，It will enhance the impact of disease on medical expenditure concentration and sustainability。Of course，There may be many other factors that cause medical expenditure concentration and persistence，such as moral risk、Medical Insurance System Design、Diagnosis and treatment quality, etc.，It is not recognized under the current data structure and technical conditions。

Not only that，Medical expenditure concentration and unique formation mechanism indicate，It is necessary to establish and improve the corresponding insurance system protection。Analysis of the characteristics of the self -payment expenditure indicates，Extension of time span，1%of the people (based on the insured) 's self -payment expenditure accounted for the proportion of all self -payment expenses of the year gradually decreased，But the reduction also decreases year by year。These statistical results indicate，Payment expenditure also has strong concentration，The burden of expenditure for high cost groups is very heavy。Comparison analysis The average self -payment ratio of the first 1%of the first 1%and the remaining 99%of the population is discovered with the trend of changes in time，The proportion of self -payment expenses of 1%of the first population (reimbursement ratio) is lower than (higher than) 99%of the people，Explain that although the total expenditure of high cost groups is higher，But the compensation obtained is more。It is worth noting that，Although there is an insurance system as a guarantee，The average self -payment ratio of high -cost people is still as high as 46%，It indicates that special major illness insurance policies are developed for this group，It should be an important focus point for the analysis of public policy。

　(Author Unit: School of Economics, Central University of Finance and Economics)