医疗保险AAPCC（调整后的人均成本）中的选择性偏差分析。
An analysis of selectivity bias in the Medicare AAPCC (adjusted average per capita cost).
作者信息
Dowd B, Feldman R, Moscovice I, Wisner C, Bland P, Finch M
机构信息
Institute for Health Services Research, School of Public Health, University of Minnesota, Minneapolis 55455, USA.
出版信息
Health Care Financ Rev. 1996 Spring;17(3):35-57.
Abstract
Using econometric models of endogenous sample selection, we examine possible payment bias to Medicare Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) risk health maintenance organizations (HMOs) in the Twin Cities in 1988. We do not find statistically significant evidence of favorable HMO selection. In fact, the sign of the selection term indicates adverse selection into HMOs. This finding is interesting, in view of the fact that three of the five risk HMOs in the study have since converted to non-risk contracts.
摘要
利用内生样本选择的计量经济学模型，我们研究了1988年明尼阿波利斯市医疗保险税公平与财政责任法案（TEFRA）风险健康维护组织（HMO）可能存在的支付偏差。我们没有发现有利于HMO选择的统计学显著证据。事实上，选择项的符号表明存在对HMO的逆向选择。鉴于该研究中五个风险HMO中有三个后来已转换为非风险合同，这一发现很有意思。
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本文引用的文献
1
Adjusting Medicare capitation payments using prior hospitalization data.利用既往住院数据调整医疗保险人头支付。
Health Care Financ Rev. 1989 Summer;10(4):17-29.
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Selection bias in health maintenance organizations: analysis of recent evidence.健康维护组织中的选择偏倚：近期证据分析
Health Care Financ Rev. 1987 Winter;9(2):55-63.
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Socioeconomic factors and Medicare supplemental health insurance.社会经济因素与医疗保险补充健康保险
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Using prior utilization to determine payments for Medicare enrollees in health maintenance organizations.利用既往医疗服务利用率来确定健康维护组织中医疗保险参保人的支付金额。
Health Care Financ Rev. 1985 Spring;6(3):27-38.
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Demographic characteristics and health care use and expenditures by the aged in the United States: 1977-1984.美国老年人的人口统计学特征、医疗保健使用情况及支出：1977 - 1984年
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6
Pre-enrollment reimbursement patterns of Medicare beneficiaries enrolled in "at-risk" HMOs.参加“风险”健康维护组织（HMO）的医疗保险受益人的预注册报销模式。
Health Care Financ Rev. 1982 Sep;4(1):55-73.
7
Risk differential between Medicare beneficiaries enrolled and not enrolled in an HMO.参加和未参加健康维护组织（HMO）的医疗保险受益人的风险差异。
Health Care Financ Rev. 1980 Winter;1(3):91-9.
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Adv Health Econ Health Serv Res. 1985;6:101-26.
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