尿毒症患者死亡率及保險商品證券化研究Modeling the Mortality Rate of ESRD Patients and Securitized Insurance Products

摘要
　　依據美國腎臟資料系統2005年全球調查結果，台灣尿毒症的發生率與盛行率自2005年起皆高居世界第一位。台灣於1995年起全民強制納入全民健康保險，尿毒症患者因獲得完善的醫療照顧而使得存活率提高。尿毒症患者的存活率改善對於全民健康保險的財務狀況及商業健康險的風險策略構成了挑戰。本文針對尿毒症的存活率改善及健康險的風險證券化轉移進行研究。利用Lin and Cox (2005)證券化程序探討年金給付照護保險金的再保費率。研究結果顯示，採用證券化除了有助於商品的定價精確，亦能長期分散死亡率改善的風險。
關鍵詞：尿毒症、全民健康保險資料庫、二因子隨機死亡率模型、長壽風險、證券化
Abstract
　　According to the United States Renal Data System, Taiwan had the highest incidence and prevalence rates for end stage renal disease (ESRD) among all countries surveyed in 2005.Though Taiwan’s National Health Insurance Program (NHIP) currently covers ESRD treatments,they are complex and costly. However, the survival rate for ESRD patients has increased dramatically, which has also increased the volume of regular, long-term medical treatment. This phenomenon has created financial challenges for the NHIP and any health insurance provider
that offers ESRD benefits. Following Lin and Cox (2005), this study proposes a mortality bond featuring bond coupon payments to address ESRD mortality improvement issue. In addition to improving the accuracy of ESRD annuity premiums, this paper demonstrates how insurance providers can reduce financial risk by securitizing insurance products.
Keywords: Longevity risk, Securitization, ESRD, Taiwan’s NHIRD, Two-factor stochastic mortality model