Research on the design of serious illness insurance scheme in Shanghai based on micro-simulation

Table 6 Annual per capita medical expenses of seriously ill patients of various medical types

Year	Number of insured persons	Number of visits	Proportion of visits (%)	Per capita cost	Std	Maximum	minimum
OOMS
2020	3,569,949	1230	0.0345	97,883	18,923	129,259	57,466
2021	3,539,690	1523	0.0430	93,226	24,974	135,021	57,576
2022	3,516,412	1537	0.0437	96,149	26,645	141,059	58,818
2023	3,593,762	1571	0.0437	99,229	28,424	147,347	60,088
2024	3,674,969	1604	0.0436	102,317	30,146	153,915	61,384
2025	3,648,586	1945	0.0533	98,461	33,467	160,775	62,709
OIMS
2020	3,569,949	819	0.0229	173,194	46,779	197,871	57,195
2021	3,539,690	1279	0.0361	138,059	68,014	209,616	60,790
2022	3,516,412	1401	0.0398	137,222	70,560	222,059	64,610
2023	3,593,762	1512	0.0421	139,710	73,580	235,240	68,671
2024	3,674,969	1575	0.0429	144,303	76,862	249,204	70,950
2025	3,648,586	1160	0.0318	124,833	82,382	263,997	71,369
BOIMS
2020	3,569,949	23,218	0.6504	137,317	31,795	187,985	80,436
2021	3,539,690	25,405	0.7177	133,027	32,093	187,551	79,487
2022	3,516,412	26,321	0.7485	132,572	31,117	187,118	78,550
2023	3,593,762	26,863	0.7475	132,371	30,269	186,686	77,624
2024	3,674,969	23,940	0.6514	132,318	24,060	156,894	98,159
2025	3,648,586	24,070	0.6597	132,157	22,761	156,748	79,516

Note: OOMS only outpatient medical services, OIMS only inpatient medical services, BOIMS both outpatient and inpatient medical services

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