A Review of Research on Medical Insurance Fraud

doi:10.19546/j.issn.1674-3830.2023.8.001

China Health Insurance ›› 2023, Vol. 0 ›› Issue (8) : 5-12. DOI: 10.19546/j.issn.1674-3830.2023.8.001

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Abstract

Medical insurance fraud has not only brought huge economic losses to the country, but also affected the quality of public medical services, which has increasingly become a shackle restricting the healthy development of the social medical insurance system. Based on the databases of China National Knowledge Infrastructure and Web of Science Core Collection to search for medical insurance fraud literature, this article uses Excel, Endnote, and VOSviewer software to conduct quantitative analysis of the literature. It is found that domestic and foreign scholars have conducted extensive research on medical insurance fraud, presenting complex and diverse subjects, means, and influencing factors of fraud, as well as comprehensive and extensive governance measures. The concept of medical insurance fraud in China needs to be further clarified, and as to the influencing factors, we should focus on fundamental factors and quantitative analysis. In terms of governance measures, it is necessary to compensate for the shortcomings of the current system and technology, and encourage more social individuals to actively participate in medical insurance anti-fraud.

Key words

medical insurance / fraud / medical insurance fraud / research review

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A Review of Research on Medical Insurance Fraud[J]. China Health Insurance. 2023, 0(8): 5-12 https://doi.org/10.19546/j.issn.1674-3830.2023.8.001

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