Insurance Management Research Articles

The Application of Fintech (Financial Technology) and Risk Management

This paper provides a comprehensive overview of the impact and applications of financial technology (Fintech) across various sectors such as payment and clearing, lending, wealth management, insurance, and risk management. It highlights the transformative potential of Fintech in enhancing financial efficiency, inclusiveness, and risk management through the utilization of modern technologies like big data, artificial intelligence, and blockchain. The paper delves into specific examples such as online payment systems, peer-to-peer lending platforms, robo-advisory services, and blockchain technology. Furthermore, it discusses the challenges and risks associated with Fintech, including regulatory issues, security concerns, and the need for effective risk management practices. The abstract emphasizes the importance of responsible risk management in ensuring financial stability and preventing systemic risks in the Fintech sector. Overall, the abstract provides a comprehensive understanding of the role of Fintech in shaping the future of the financial industry and emphasizes the need for effective regulation, risk management, and technological innovation to harness its full potential while mitigating associated risks.

Individual Buffalo Identification Through Muzzle Dermatoglyphics Images using Deep Learning Approaches

Animal identification is essential for routine farm operations, residue traceback, insurance, and ownership management. Owing to their uniqueness, incorrigible nature, tamperproof over time, environment-friendly, and pain-free, visual biometrics-based animal identification has recently gained momentum over traditional animal identification methods. Among visual biometrics-based cues, muzzle identification is a simple and relatively low-cost method. Therefore, to address the inherent significant limitations of conventional animal identification systems, we undertook this investigation to collect a database of digital images of muzzles that works as a benchmark, to apply deep learning frameworks to identify individual buffaloes from their muzzle images, and to compare their accuracy in terms of their identification capabilities. Muzzle images of 198 Surti buffaloes were subjected to transfer learning and fine-tuning processes in deep-learning neural networks. The performance was recorded for each pre-train model (ResNet50, InceptionV3, VGG16, AlexNet) with different hyperparameters of the epoch, batch size, and learning rate. A perusal of the data revealed that ResNet50 has the highest train accuracy (99.8%) and test accuracy (99.69%) among all four models used. AlexNet has the lowest train accuracy (90.8%) among the models. The findings concluded that all these four models could be applied to identify individual buffaloes; however, ResNet50 had the highest accuracy, and deep learning applications have great potential for individual buffalo identification and are promising tools for precision livestock farming

The Impact of Air Pollution Risk on the Sustainability of Crop Insurance Losses

Climate change poses significant risks to natural and economic environments, particularly through its interaction with air pollution. As agriculture is vital for national production, and crop insurance supports social security, it is crucial to examine how air pollution affects crop insurance. Here, we quantify the impact of air quality on crop insurance claims from an actuarial perspective and evaluate the implications for the industry. Utilizing claims data from the U.S., we explore the potential of particulate matter (PM2.5) as a predictor of insurance claims, building on literature that highlights its economic damage to crops. Through the application of a generalized additive model (GAM) and extreme gradient boosting, we found that PM2.5 is indeed a factor influencing crop insurance indemnity in both models, with the GAM demonstrating superior predictive performance. Furthermore, we employed Bai and Perron breakpoint analysis to elucidate the relationship between PM2.5 levels and crop insurance claims over time, alongside two-way fixed effects models to investigate its correlation with various crop types. Our findings highlight the need for crop insurance managers to integrate air quality considerations into their risk processes to ensure sustainability of the industry and pricing strategy in the face of evolving environmental challenges.

Analysis of the structure and trend prediction of China's total health expenditure.

In the context of rapid economic and social development, there has been a continuous intensification of population aging, transformation of disease patterns, and wide application of new medical technologies. As a result, health expenditures in various countries have sharply soared. How to utilize limited medical resources to maximize the improvement of health levels has become a hot and challenging issue related to the well-being of all humanity. The relevant indicators of total health expenditure play a crucial role in monitoring and evaluating the fairness of health financing and health security in the region. This study explores the changes in the main expenses that constitute China's total health expenditure and uses indicators related to health expenditure to observe the changes and future development trends of China's health expenditure. Based on this, the utilization of China's health expenditure is monitored to identify possible problems, and thereby targeted suggestions for promoting the development of China's health and wellness cause are put forward. Based on the comparison of previous literature, this paper analyzes the changes and future development trends in China's health expenditure by using the relevant indicators of China's health expenditure through the structural variation analysis method and the gray prediction model. The results show that the scale of government, social, and out-of-pocket health expenditures has continuously expanded, with social health expenditures becoming the main funding source for total health expenditures. The burden of medical expenditures on individuals has been further reduced. In the institutional method of total health expenditures, hospital expenditures account for about 60% of the total and are the main component. The expenditures of health administration and medical insurance management institutions are the main driving force behind the growth of total health expenditures. However, the proportion of health expenditures in China's GDP is relatively low, so more investment is needed in the healthcare sector, and the burden of individual medical expenses also needs to be continuously reduced. In the future, China should further increase its investment in the medical and health sector. Specifically, the government should persist in investing in fundamental medical and health services. Simultaneously, efforts should be made to establish a scientific cost control mechanism for pharmaceuticals and broaden financing channels for healthcare, such as accelerating the development of commercial health insurance.

Financial Sustainability of Social Insurance: The Case of Korean Workers’ Compensation Insurance and Possibility of Triple Moral Hazard

Abstract This study examines the economic stability of Korean Workers’ Compensation Insurance (WCI), highlighting the system’s vulnerability to triple moral hazard. Korean WCI features more generous worker compensation, lower employer premiums, and more active government involvement in accident prevention in addition to a higher industrial accident rate, compared to the system in Germany and Japan. The negotiation process of the WCI among workers, employers, and insurance managers often prioritizes short-term benefits, undermining long-term financial health. Workers seek greater compensation, employers push for lower premiums, and insurance managers may prioritize collective interests, exacerbating the system’s economic instability. Over recent years, applications for occupational disease recognition have surged, and premium rates have decreased, indicating increasing strain. To mitigate these issues, the study proposes enhancing transparency and rationality, involving non-political experts in decision-making, and clearly defining the government’s role in managing WCI. These measures aim to balance stakeholder interests and ensure the WCI system’s sustainability for future generations.

Manajemen Risiko terhadap Nilai Klaim Asuransi Rangka Kapal Berdasarkan ITC (Institute Time Clause) Hull 1.10.83 Clause 280 (All Risks Comprehensive) Pada Kapal BG. TRG 06

This qualitative study aims to examine the implementation of risk management in hull insurance by collecting data through interviews with the risk management staff of Asuransi Mitra Pelindung Mustika Ltd. The findings revealed that this company has applied the risk management process, including risk identification, risk analysis, risk evaluation, risk control, risk transfer through other insurance policies, monitoring, and review. The company covers losses due to fire, explosion, violent theft, piracy, accidents involving installations, collisions with aircraft or similar objects, earthquakes, volcanic eruptions, lightning strikes, accidents during loading or refuelling, boiler explosions, machinery shaft breakage, or latent defects in the machinery, hull, or frame of the insured vessel. Asuransi Mitra Pelindung Mustika Ltd. also compensates for losses due to the negligence of the captain, officers, or crew of the insured vessel, as well as the shipyard. Time to process the claim becomes a significant challenge in fulfilling the insured's rights in the claim for the BG. TRG 06 vessel because it takes up to 14 days to gather all the necessary documents. This company will cover all repair costs and labor expenses, with an estimated total value of IDR 7,611,100,000.00.

Predicting patent lawsuits with machine learning

We use machine learning methods to predict which patents end up in court using the population of US patents granted between 2002 and 2005. We show that patent characteristics have significant predictive power, particularly value indicators and patent-owner characteristics. Furthermore, we analyze the predictive performance concerning the number of observations used to train the model, which patent characteristics to use, and which predictive model to choose. We find that extending the set of patent characteristics has the biggest positive impact on predictive performance. The model choice matters as well. More sophisticated machine learning methods provide additional value relative to a simple logistic regression. This result highlights the existence of non-linearities among and interactions across the predictors. Our results provide practical advice to anyone building patent litigation models, e.g., for litigation insurance or patent management more generally.

Healthcare workers’ perceptions and user experiences of biometric technology in the selected healthcare facilities in Zambia

BackgroundBiometric recognition, using traits like fingerprints, faces, and irises, has advanced significantly, enabling accurate identification. Despite progress, implementation in Zambian healthcare is limited. This study explored healthcare workers’ and patients' perceptions and experiences regarding biometric technology in Zambian healthcare settings, offering insights for informed decision-making and product design.MethodsThis phenomenological study explored the perceptions and experiences of healthcare workers and end-users (patients) concerning biometric technology in four healthcare facilities in Lusaka Province: Chilenje, Chawama, Kanyama (first-level hospitals), and Railways Urban Clinic. These facilities were purposefully selected for their active use of biometric services and involvement with the National Health Insurance Management Authority (NHIMA). The study included 20 healthcare workers and 16 patients. Face-to-face interviews with healthcare workers and patients, and focus group discussions with users, lasting 35 to 65 min, were conducted. Interviews were audio-recorded, transcribed verbatim, coded with Nvivo version 12, and analyzed using inductive thematic analysis.ResultsFacilitators included efficient system integration, investment in biometric equipment, workflow transformation, and patient recognition of benefits. Barriers included infrastructure limitations, technical challenges, patient resistance and misconceptions, and accessibility challenges for individuals with disabilities.ConclusionThis study highlights the transformative potential of biometric identification systems in healthcare, emphasizing benefits in efficiency and data integrity. Successful integration requires addressing facilitators like education and infrastructure and mitigating barriers such as cultural resistance and technological limitations. Stakeholders, including policymakers and healthcare providers, can use these insights to align efforts with Sustainable Development Goals for improved healthcare access and reduced inequalities. Considering user perspectives is crucial for effective implementation, and continuous improvement can enhance healthcare delivery and patient outcomes.

A Critical Analysis of Challenges and Prospects of the National Health Insurance Scheme in Zambia-A Case Study of Lusaka District

Zambia’s National Health Insurance (NHI) was established by the enactment of the NHI Act No. 2 of 2018 and supported by statutory instrument No. 63 of 2019 which led to the establishment of the National Health Insurance Scheme (NHIS) under the management of the National Health Insurance Management Authority (NHIMA). The goal of the NHIS was to guarantee the provision of universal health insurance coverage for all residents, regardless of their socioeconomic status. As one of the prospective financing solutions for protecting populations from high health care service prices, NHIS is receiving increased attention from the international community. This study set out to investigate the difficulties and opportunities that the plan faces from the standpoint of the service providers and subscribers in Lusaka, Zambia. The study used the descriptive research design since it seeks to analyze the prospects and challenges of the national health insurance scheme in Lusaka, Zambia. The study came to a conclusion that in Lusaka, Zambia, consumers who wish to utilize the NHIS plan face challenges related to health literacy and awareness, fraud, and corruption, as well as, subpar service quality. The survey also discovered that consumers in Lusaka have difficulties with enrolment and registration while attempting to use the NHIS program due to intermittent availability and constant breakdown of the NHIMA system. The study further came to conclude that some of the prospects for the NHIS plan in Lusaka is public knowledge and involvement, enhancing monitoring and evaluation of the private and public health facilities accredited with NHIMA and improving the internet connectivity of the NHIMA system to enhance service delivery.

Three-dimensional analysis of China's fisheries insurance policy: A tool-direction-subject perspective

ObjectiveInsurance for fisheries ensures the stability of fishing areas and stabilizes fishermen's lives. This research, derived from a numerical examination of 374 documents on China's fishery insurance policies, delves into the emphasis and limitations of current policies, offering guidance for developing and refining future fishery insurance strategies for both China and the globe. MethodsThe research develops a 3D analytical model encompassing policy instruments, directions, and stakeholders, examining how China's fishery insurance policies are distributed and utilized via classification of policy tools, coding of text content, statistical analysis, and complex interactions. ResultsRegarding policy instruments, those based on environmental considerations were the most commonly employed, while those based on demand were the least utilized. In terms of policy direction, it is biased towards supporting strategies such as organizing and implementing work and optimizing insurance operation mechanism. In terms of policy stakeholders, it is mostly reflected in the characteristics of policy implementation under the leadership of the government, while the initiative and participation of fishermen, fishery management organizations and insurance management institutions is not high enough. ConclusionGoing forward, both China and the global community ought to focus on these three aspects when developing fishery insurance policies. First, it's essential to broaden the impact of policy instruments that are based on demand and supply. Second, refine the policy tool guidance measures based on policy direction. Third, it is necessary to stimulate the vitality of policy-driven multi-agent participation.

A novel central bank digital currency framework design for offline and foreign transactions based on blockchain

Purpose Fiat money production necessitates physical commodities, increasing costs and its flow is challenging to monitor, making it vulnerable to criminal exploitation. Cryptocurrencies offer decentralized solutions, but their decentralization has led to illegal activities. Current cross-border transactions face high costs, resource intensity and lack of instant currency transfers. Offline transactions are essential in unreliable networks. Design/methodology/approach Here, the authors proposed the methodology to perform offline transactions based on card, quick response (QR) code and a foreign transaction framework with universal identification (UID) to perform cross-border transactions using blockchain-dependent central bank digital currencies (CBDCs). Implications for the financial system are also analyzed. Findings The proposed CBDC framework reduces illegal transactions, corruption and the cost of producing fiat money; eases overseas transactions; and eventually increases international tourism, trade and business between countries. It also reduces the processing fees. Offline framework found useful for performing retail-level transactions. Research limitations/implications The research methodology may face limitations due to diplomatic relations, political instability, sanctions and the need for robust offline transaction infrastructure. Practical implications The proposed CBDC framework simplifies debt and insurance management, tax collection, international trade, tourism and global stock market participation. However, implementing CBDCs in low-income countries presents challenges like extensive training, infrastructure and user acceptance issues. Social implications The adoption of CBDCs can enhance financial stability by reducing corruption and illegal transactions through improved traceability and monitoring, thereby curbing activities like terrorism. Originality/value Common framework for foreign transactions is based on the UID, and offline transaction framework is based on the sender’s QR code for multiple user applications.

EEMD-ARIMA Model for annual precipitation forecasting to aid weather insurance decision-making research

Climate risk poses significant threats to human life and property. Climate insurance can effectively mitigate and disperse these risks. This paper addresses the weakness in weather risk prediction for climate insurance formulation by combining Ensemble Empirical Mode Decomposition (EEMD) and Autoregressive Integrated Moving Average (ARIMA) models. Four models, namely EMD, EEMD, ARIMA, and EMD-ARIMA, were established for modeling and forecasting Chinas annual precipitation data. The results show that the EEMD-ARIMA model can suppress the modal aliasing problem in time series and has the best fit compared to other models. This model can more accurately describe the variation in annual precipitation in forecasting applications, providing significant predictive value for insurance companies and government decisions regarding insurance and climate risk management.

Effect of Financial Literacy and Use of Financial Technology (FinTech) on Financial Behavior

Research Aims: Analyzing the Influence of Financial Literacy and the Use of Financial Technology (FinTech) on Financial Behavior in Bandung Regency Micro, Small and Medium Enterprises (MSMEs). Design/methodology/approach: This research uses a quantitative approach through correlational methods. Research Findings: The research results found: 1). Financial literacy has a positive and significant effect on financial behavior variables. 2). The use of financial technology (FinTech) has a positive and significant effect on financial behavior variables. 3). Financial literacy and the use of financial technology (FinTech) positively and significantly affect the financial behavior of micro, small and medium enterprises (MSMEs) in Bandung Regency. Theoretical Contribution/Originality: Further increase knowledge of financial management by actively participating in workshops or seminars related to financial management, insurance, investment and business fund management. And increasing financial technology (FinTech) knowledge by orienting to the latest news regarding technological developments in up-to-date financial products and services.

The cross-regional settlement methods in hospitals and the treatment-seeking behavior of patients with malignant tumors in China: an evolutionary game model.

Cross-regional settlement management is a key indicator of national health insurance system maturity. Given the significant demand for cross-regional medical treatment among Chinese patients with malignant tumors and the territorially managed health insurance system, further research is necessary to explore the relationship between hospital settlement methods and treatment-seeking behaviors among these patients. This study introduces and validates an evolutionary game model that provides a theoretical foundation for direct settlement policies in cross-regional treatment. An evolutionary game model was constructed with patients and hospitals serving as strategic players within a dynamic system. This model integrates the patients' treatment utility, medical and nonmedical costs, and hospitals' financial and technological advancement benefits. The evolutionary stability analysis revealed seven-game outcomes between hospitals and patients with malignant tumors. The numerical simulations suggest an evolutionary convergence toward strategy (1, 0), indicating a trend where patients with malignant tumors opt for cross-regional treatment, yet hospitals choose not to implement a direct settlement policy. Parameter sensitivity analysis showed that the parameters set in this study affected player behavioral choices and game equilibria. A strong demand for cross-regional medical treatment among Chinese patients with malignant tumors, and some hospitals require more incentives to implement cross-regional settlements. The key factors influencing the willingness of some patients with malignant tumors to resettle include the costs of in-area medical care, costs of cross-regional treatment without direct settlement, and the utility of cross-regional treatment. Technological advancement benefits and input costs influence some hospitals' motivation to adopt cross-regional settlements. Policy adjustments that effectively implement direct settlement policies can facilitate equilibrium, enhance the initiatives of some local health insurance management departments, improve the accessibility and efficiency of medical services, and reduce nonmedical expenses for patients.

STUDI KOMPARATIF ANTARA ASURANSI SYARIAH DENGAN ASURANSI KONVENSIONAL: SEJARAH, SUMBER HUKUM, MAYSIR, GHARAR, RIBA, DEWAN PENGAWAS SYARIAH, PENGELOLAAN RESIKO DAN PREMI

The purpose of this study is to compare Conventional Insurance with Sharia Insurance in terms of principles, history, legal basis, clean from Maghrib (maisir, gharar, and riba), Sharia Supervisory Board, risk management, and premi. The research method employed is a literature review with a descriptive approach, which is part of qualitative research. The descriptive approach is chosen to depict the distinctions between Sharia and Conventional insurance. The findings reveal significant differences across all aspects examined between Conventional and Sharia Insurance. Conventional Insurance traces its history back to Babylonian practices around 4000-3000 BC, notably the Code of Hammurabi, while Sharia Insurance originates from pre-Islamic Arab customs (aqilah system), later sanctioned by Prophet Muhammad, drawing legal sources from positive law and fatwas from DSN-MUI. Conventional Insurance incorporates elements of maysir, gharar, and riba in its operations, which are absent in Sharia Insurance. Unlike Conventional Insurance, Sharia Insurance has an internal Sharia Supervisory Board to ensure compliance with Sharia principles. Risk management in conventional insurance involves transfer of risk, whereas Sharia Insurance focuses on sharing of risk. Premi in Conventional Insurance consist of mortality tables, interest, and insurance costs, whereas Sharia Insurance premi consist of tabarru’ (donation) and savings (for life insurance), or tabarru’ alone (for non-life insurance). The tabarru’ element is derived from mortality tables without interest calculations.

Effect of Net Interest Margin on Financial Performance of Deposit Money Banks in Nigeria

The study investigated the effect of net interest margin on financial performance of deposit money banks in Nigeria. The researcher developed four specific objectives, four research questions and four hypotheses that guided the study. The research design employed was ex post facto. This design is selected and implemented due to the researcher's lack of control over the various elements of the design. The data for this study is preexisting, therefore it is utilized for a secondary data analysis. The study's population comprised twenty-two (22) designated deposit money banks in Nigeria. This study employed the judgmental sampling technique. The sample size is made up of two (2) DMBs which includes United Bank for Africa Plc, Fidelity. The data for this study were obtained from the published financial statements of the chosen publicly traded deposit money banks in Nigeria. This study employed an estimated technique that involved the use of descriptive statistics and Ordinary Least Squares (OLS) regression analysis. The E-view-9 software was utilized to carry out the analysis. The study established that net interest margin is statistically significant and has a positive effect on operating income (OI). The researchers suggested that Banks should monitor and manage the duration gap between assets and liabilities, considering potential interest rate changes and the bank's risk appetite. Banks should explore opportunities to diversify income sources by offering a broader range of financial products and services, such as wealth management, insurance, and asset management.

The settlement mechanism of diagnosis-intervention packet payment scheme in China：A policy review and lessons learned

The settlement of the medical insurance fund is the key point of the implementation of the big data diagnosis & intervention packet (DIP) under the regional global budget. This study proposed the framework with key methods for the settlement of DIP on medical insurance funds through on-site survey and policy literature analysis. The results show that the settlement framework, featuring “Fund pre-allocation”, “Monthly pre-settlement” and “Annual settlement”, integrates ideas of both the pre-payment system and post-payment system. “Monthly pre-settlement” being the key part of the settlement process, plays an important role in breaking down the year-end pressure of medical insurance management organizations and healthcare institutions, and guiding providers' reasonable behaviors. “Annual settlement” acts as the core link of settlement, which determines the annual medical insurance fund payment amount of healthcare institutions, which needs to rely on and integrate key elements such as regional global budget, DIP grouping database and correction, and healthcare institution supervision and assessment. The settlement process, measurement methods, and key parameters must be clarified by introducing settlement and related supporting policies, which provide technical support and institutional guarantees for the implementation and effectiveness of the DIP reform.

Effects of Emotional Labor and Job Stress Perceived by Insurance and Asset Managers on Their Job Satisfaction.

Occupational stress is often high among the employees of insurance companies. We aimed to examine the effects of emotional labor and job stress on job satisfaction among insurance and asset managers and the moderating effect of regular exercise participation in these relationships. This study was conducted in October 2022. A total of 261 insurance and asset managers working at Samsung Life Insurance Company, Seoul, Republic of Korea, were selected using non-probability purposive sampling. Data were collected using questionnaires. The data collected were analyzed using frequency analysis, descriptive statistics, confirmatory factor analysis, correlation analysis, structural equation model analysis, measurement equivalence tests, multi-group structural equation model analysis, and parametric comparison analysis. Both emotional labor and job stress had a negative effect on the job satisfaction of insurance and asset managers (P< 0.05). Regular exercise participation moderated the relationship between emotional labor and job satisfaction (P< 0.05) but not the relationship between job stress and job satisfaction. The results of this study might help encourage devising of strategies that increase exercise participation among insurance and asset managers in order to reduce their emotional labor and job stress while simultaneously increasing their job satisfaction.

Optimal reinsurance under a new design: two layers and multiple reinsurers

We investigate the optimal reinsurance problem considering a more realistic two-layer design involving excess-of-loss reinsurance and multiple reinsurers. Unlike the commonly assumed single-layer design in the existing literature, our approach involves a top layer consisting of excess-of-loss reinsurance and the involvement of multiple reinsurers. Our focus is on the insurer's management of risk exposure and costly capital reinvestment strategies to maximize the company value. We formulate this problem as an optimization problem with constrained multivariate reinsurance exposure variables, and capital injection control. Our findings show that, from a profitability standpoint, when the surplus is low and the excess-of-loss reinsurance is not too expensive, the insurer should obtain a two-layer reinsurance with an excess-of-loss reinsurance at the top layer and a combination of proportional reinsurance from multiple reinsurers at the bottom layer. In contrast, when the surplus is relatively large or the excess-of-loss reinsurance is too expensive, the insurer should purchase a single-layer proportional reinsurance from multiple reinsurers. When the surplus is large enough, the insurer should not acquire any reinsurance. Our results suggest that stand-alone excess-of-loss reinsurance is never optimal when there is also proportional reinsurance with a variance premium principle available for losses below the excess threshold, and we theoretically confirm that a multi-layer reinsurance design is preferable over a single-layer design. Furthermore, our results demonstrate that in order to maximize the company's value, dividends should be paid according to the lump-sum barrier strategy, and capital injections should be considered only if the surplus is null and the transaction costs on capital injections are not too high.

The usage and costs of national drug price-negotiated anticancer medicines in a first-tier city in Northeast China: a study based on health insurance data

BackgroundThe National Drug Price Negotiation (NDPN) policy has entered a normalisation stage, aiming to alleviate, to some extent, the disease-related and economic burdens experienced by cancer patients. This study analysed the use and subsequent burden of anticancer medicines among cancer patients in a first-tier city in northeast China.MethodsWe assessed the usage of 64 negotiated anticancer medicines using the data on the actual drug deployment situation, the frequency of medical insurance claims and actual medication costs. The affordability of these medicines was measured using the catastrophic health expenditure (CHE) incidence and intensity of occurrence. Finally, we used the defined daily doses (DDDs) and defined daily doses cost (DDDc) as indicators to evaluate the actual use of these medicines in the region.ResultsDuring the study period, 63 of the 64 medicines were readily available. From the perspective of drug usage, the frequency of medical insurance claims for negotiated anticancer medicines and medication costs showed an increasing trend from 2018 to 2021. Cancer patients typically sought medical treatment at tertiary hospitals and purchased medicines at community pharmacies. The overall quantity and cost of medications for patients covered by the Urban Employee Basic Medical Insurance (UEBMI) were five times higher than those covered by the Urban and Rural Resident Medical Insurance (URRMI). The frequency of medical insurance claims and medication costs were highest for lung and breast cancer patients. Furthermore, from 2018 to 2021, CHE incidence showed a decreasing trend (2.85–1.60%) under urban patients’ payment capability level, but an increasing trend (11.94%–18.42) under rural patients’ payment capability level. The average occurrence intensities for urban (0.55–1.26 times) and rural (1.27–1.74 times) patients showed an increasing trend. From the perspective of drug utilisation, the overall DDD of negotiated anticancer medicines showed an increasing trend, while the DDDc exhibited a decreasing trend.ConclusionThis study demonstrates that access to drugs for urban cancer patients has improved. However, patients’ medical behaviours are affected by some factors such as hospital level and type of medical insurance. In the future, the Chinese Department of Health Insurance Management should further improve its work in promoting the fairness of medical resource distribution and strengthen its supervision of the nation’s health insurance funds.