沈建美^1，， 李连友^1，2，*， 薛珂^1，

（  1、湖南大学金融与统计学院，长沙 410079；       2、湖南大学法学院，长沙 410082；  ）

摘要： 本文引入欺诈三角理论对社会医疗保险欺诈行为进行研究，从机会、动机、合理化借口三个维度探讨影响欺诈行为的因素，并通过调研社会医疗保险欺诈情况所得到的数据进行实证研究，即建立线性回归模型对影响因素进行定量分析，结果发现：补偿报复心理、医院吸引患者的心理以及社保机构监管和审查力度对社会医疗保险欺诈行为的影响比较显著。????
关键词： 社会医疗保险；保险欺诈；欺诈三角理论；线性回归模型

SHEN Jianmei^1,， LI Lianyou^1,2,*， XUE Ke^1,

（  1、College of Finance & Statistics，Hunan University，Changsha 410079；       2、 Law School,Hunan University,Changsha 410082；  ）

Abstract： In this paper we used the Fraud Triangle to study social medical insurance fraud, and we discuss the factors influence the behavior of fraud through three dimensions which are opportunity, motivation and rationalization. We conducted empirical research by the data obtained in the investigation of medical insurance fraud. By linear regression model quantitative factors influencing analysis, we can identify the main factors of social insurance fraud. The results showed that compensation for revenge, hospital attract patients and social security institutions supervision and censorship is significant for the influence of the social medical insurance fraud.
Keywords： Social Medical Insurance; Insurance Fraud; Fraud Triangle; Linear Regression Model

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