Objective: This study attempts to analyze the constraints on the development of commercial health insurance, providing a basis and reference for the high-quality development of commercial health insurance. Methods: Using a thematic framework analysis, semi-structured interviews were conducted with 32 professionals. NVivo12 Plus software was employed for thematic coding. Results: The challenges faced by commercial health insurance include imbalanced product structure, low security levels, mismatch between products and demands, and weak risk management and actuarial techniques. After analysis, 21 sub-themes and 7 main themes were identified. These interconnected themes and sub-themes collectively contribute to the formation of a model outlining the factors hindering the development of commercial health insurance. Conclusion: In response to the challenges faced by commercial health insurance, corresponding strategic suggestions are proposed, including issuing policies to accelerate the rapid development of the commercial health insurance market, leveraging commercial health insurance catalogs to promote integration with social health insurance, encouraging innovation in product development within specialized areas of commercial health insurance, and ensuring the sustainability of inclusive commercial health insurance.
Key words
thematic framework analysis /
commercial health insurance /
model construction
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