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基于Apriori-XGB的医保反欺诈预警模型研究

吴建宇,张昕,郑文珍, 翁雯璇, 董火荣

Industrial & Science Tribune（2021）

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Abstract
在中国医疗保险行业迅速发展的同时,医保欺诈现象也频繁地出现.本研究将针对医保欺诈行为的性质,利用XGB算法和Apriori算法建模并挖掘欺诈规律,从而构建一个完整且高效的医保反欺诈预警系统模型,帮助医院识别医保欺诈行为,减少医保欺诈风险.
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