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医疗保险受益人的处方药支出可预测性。

Predictability of prescription drug expenditures for Medicare beneficiaries.

作者信息

Wrobel Marian V, Doshi Jalpa, Stuart Bruce C, Briesacher Becky

机构信息

University of Pennsylvania School of Medicine, USA.

出版信息

Health Care Financ Rev. 2003 Winter;25(2):37-46.

Abstract

MCBS data are used to analyze the predictability of drug expenditures by Medicare beneficiaries. Predictors include demographic characteristics and measures of health status, the majority derived using CMS' diagnosis cost group/hierarchical condition category (DCG/HCC) risk-adjustment methodology. In prospective models, demographic variables explained 5 percent of the variation in drug expenditures. Adding health status measures raised this figure between 10 and 24 percent of the variation depending on the model configuration. Adding lagged drug expenditures more than doubled predictive power to 55 percent. These results are discussed in the context of forecasting, and risk adjustment for the proposed new Medicare drug benefit.

摘要

医疗保险成本与效益调查(MCBS)数据用于分析医疗保险受益人的药品支出可预测性。预测因素包括人口统计学特征和健康状况指标,其中大部分是使用医疗保险与医疗补助服务中心(CMS)的诊断成本组/分层疾病类别(DCG/HCC)风险调整方法得出的。在前瞻性模型中,人口统计学变量解释了药品支出变化的5%。根据模型配置,加入健康状况指标后,这一数字提高到了支出变化的10%至24%。加入滞后药品支出后,预测能力增加了一倍多,达到55%。将在预测以及拟议的新医疗保险药品福利的风险调整背景下讨论这些结果。

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