Predicting healthcare expenditure by multimorbidity groups

[EN] Objectives: This article has two main purposes. Firstly, to model the integrated healthcare expenditure for the entire population of a health district in Spain, according to multimorbidity, using Clinical Risk Groups (CRG). Secondly, to show how the predictive model is applied to the allocation...

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Detalhes bibliográficos
Autores: Caballer-Tarazona, Vicent, Guadalajara Olmeda, María Natividad|||0000-0002-5992-3446, Vivas-Consuelo, David|||0000-0003-2945-7525
Tipo de documento: artigo
Data de publicação:2019
País:España
Recursos:Universitat Politècnica de València (UPV)
Repositório:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
Idioma:inglês
OAI Identifier:oai:riunet.upv.es:10251/157298
Acesso em linha:https://riunet.upv.es/handle/10251/157298
Access Level:Acceso aberto
Palavra-chave:Budget
Case-mix system
Health econometrics
Healthcare expenditure
Multimorbidity
Risk adjustment
Two-part models
ECONOMIA APLICADA
ECONOMIA, SOCIOLOGIA Y POLITICA AGRARIA
Descrição
Resumo:[EN] Objectives: This article has two main purposes. Firstly, to model the integrated healthcare expenditure for the entire population of a health district in Spain, according to multimorbidity, using Clinical Risk Groups (CRG). Secondly, to show how the predictive model is applied to the allocation of health budgets. Methods: The database used contains the information of 156,811 inhabitants in a Valencian Community health district in 2013. The variables were: age, sex, CRG's main health statuses, severity level, and healthcare expenditure. The two-part models were used for predicting healthcare expenditure. From the coefficients of the selected model, the relative weights of each group were calculated to set a case-mix in each health district. Results: Models based on multimorbidity-related variables better explained integrated healthcare expenditure. In the first part of the two-part models, a logit model was used, while the positive costs were modelled with a log-linear OLS regression. An adjusted R-2 of 46-49% between actual and predicted values was obtained. With the weights obtained by CRG, the differences found with the case-mix of each health district proved most useful for budgetary purposes. Conclusions: The expenditure models allowed improved budget allocations between health districts by taking into account morbidity, as opposed to budgeting based solely on population size.