Developing the administrative model using the data mining technique for injury in National Health Insurance
Il-Su Park, Jun‐Tae Han, Hae‐Sook Sohn, Suk-Bok Kang · Journal of the Korean Data and Information Science Society · 2011
We developed the hybrid model coupled with predictive model and business rule model for administration of injury by utilizing medical data of the National Health Insurance in Korea. We performed decision tree analysis using data mining methodology and used SAS Enterprise Miner 4.1. We also investigated under several business rule for benefits (expense paid by insurer) and claims of injury in National Health Insurance Corporation. We can see that the proposed hybrid model provides a quite efficient plausible results.