以全民健康保險研究資料庫為基礎之住院與門診手術發生率統計Empirical statistics of inpatient and outpatient surgeries based

摘要
　　微創手術技術的發展以及手術分類的細膩化，不但對於手術發生率的變化產生影響，同時衝擊手術醫療保險商品的設計與定價。以即時且精確的手術發生率為基礎所研發的保險契約，可以兼顧被保險人及保險人對於公平定價及風險衡量的基本需求。據此，本研究利用全民健康保險研究資料庫2005年承保抽樣歸人檔，對於「全民健康保險醫療費用支出標準」的各項手術項目進行性別及年齡分類的發生率統計，所得結果提供精算人員商品設計與風險管理人員風險評估的參考。
關鍵詞：手術醫療保險、全民健康保險研究資料庫、全民健康保險醫療費用支出標準、2005年承保抽樣歸人檔
Abstract
　　The development of minimally invasive surgical techniques and refined surgical classifications impacts not only the incidence of surgical procedures but also the design and pricing of surgery-related medical insurance products. Product designs based on precise and recent statistics can take into account the needs of both the insured and the insurer for fair pricing and risk measurement. In this paper, empirical statistics of inpatient and outpatient surgeries are provided based on the Longitudinal Health Insurance Database in 2005 derived from the National Health Insurance Research Database. The results can be used for pricing surgical medical insurance.
Keywords: Surgical medical insurance, National Health Insurance Research Database, National Health Insurance expenditure standards, Longitudinal Health Insurance Database