利用医疗保险当前受益人调查（MCBS）中的健康状况指标来改善调整后人均成本（AAPCC）。
Improving the AAPCC (adjusted average per capita cost) with health-status measures from the MCBS (Medicare Current Beneficiary Survey).
作者信息
Gruenberg L, Kaganova E, Hornbrook M C
机构信息
DataChron Health Systems, Inc., Cambridge, MA 02139, USA.
出版信息
Health Care Financ Rev. 1996 Spring;17(3):59-75.
Abstract
Using data from the 1991 Medicare Current Beneficiary Survey (MCBS), multiple regression-based models predicting 1992 Medicare costs are developed and compared. A comprehensive model incorporating demographic, diagnostic, perceived health, and disability variables is shown to be stable and to fit the data well over the full range of Medicare-covered annual per capita expenses and for a variety of beneficiary subgroups defined by their health and functional status. This model produces stable unbiased estimates of expenditures on validation samples. A variant of this model is being considered for use in setting Medicare capitation payments for the second phase of the social/health maintenance organization (S/HMO) demonstration.
摘要
利用1991年医疗保险当前受益调查（MCBS）的数据，开发并比较了基于多元回归的预测1992年医疗保险费用的模型。一个综合了人口统计学、诊断、自我感知健康和残疾变量的模型被证明是稳定的，并且在医疗保险覆盖的人均年度费用的整个范围内以及对于由健康和功能状态定义的各种受益人群体都能很好地拟合数据。该模型对验证样本的支出产生稳定无偏的估计。正在考虑将该模型的一个变体用于为社会/健康维护组织（S/HMO）示范的第二阶段设定医疗保险按人头付费。
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本文引用的文献
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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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Adjusting capitation using chronic disease risk factors: a preliminary study.利用慢性病风险因素调整人头费：一项初步研究。
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Capitation pricing: adjusting for prior utilization and physician discretion.按人头定价：根据既往医疗服务利用率和医生的自由裁量权进行调整。
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Functional health measure for adjusting health maintenance organization capitation rates.用于调整健康维护组织按人头付费率的功能健康指标。
Health Care Financ Rev. 1986 Spring;7(3):85-95.
7
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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Using health indicators in calculating the AAPCC (adjusted average per capita cost).
Adv Health Econ Health Serv Res. 1989;10:75-109.
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The health status and utilization patterns of the elderly: implications for setting Medicare payments to HMOs.老年人的健康状况及使用模式：对医疗保险机构向健康维护组织支付费用的影响
Adv Health Econ Health Serv Res. 1989;10:41-73.
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A profile of the Medicare Current Beneficiary Survey.医疗保险当前受益人调查概况。
Health Care Financ Rev. 1994 Summer;15(4):153-63.
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