Carreras Marc, Sánchez-Pérez Inma, Ibern Pere, Coderch Jordi, Inoriza José María
Research group on health services and health outcomes (GRESSIRES) - Serveis de Salut Integrats Baix Empordà (SSIBE) and Universitat de Girona, ES.
Research group on health services and health outcomes (GRESSIRES) - Serveis de Salut Integrats Baix Empordà (SSIBE), ES.
Int J Integr Care. 2016 Aug 19;16(3):10. doi: 10.5334/ijic.2422.
The objective of this study is to investigate whether the algorithm proposed by Manning and Mullahy, a consolidated health economics procedure, can also be used to estimate individual costs for different groups of healthcare services in the context of integrated care.
A cross-sectional study focused on the population of the Baix Empordà (Catalonia-Spain) for the year 2012 (N = 92,498 individuals). A set of individual cost models as a function of sex, age and morbidity burden were adjusted and individual healthcare costs were calculated using a retrospective full-costing system. The individual morbidity burden was inferred using the Clinical Risk Groups (CRG) patient classification system.
Depending on the characteristics of the data, and according to the algorithm criteria, the choice of model was a linear model on the log of costs or a generalized linear model with a log link. We checked for goodness of fit, accuracy, linear structure and heteroscedasticity for the models obtained.
The proposed algorithm identified a set of suitable cost models for the distinct groups of services integrated care entails. The individual morbidity burden was found to be indispensable when allocating appropriate resources to targeted individuals.
本研究的目的是调查曼宁和穆拉希提出的一种综合健康经济学程序算法，在综合医疗背景下是否也可用于估算不同医疗服务群体的个体成本。
一项横断面研究聚焦于2012年西班牙加泰罗尼亚地区下埃姆波达的人群（N = 92498人）。调整了一组作为性别、年龄和发病负担函数的个体成本模型，并使用回顾性全成本核算系统计算个体医疗成本。使用临床风险组（CRG）患者分类系统推断个体发病负担。
根据数据特征并按照算法标准，模型选择为成本对数的线性模型或具有对数链接的广义线性模型。我们对所得模型的拟合优度、准确性、线性结构和异方差性进行了检验。
所提出的算法为综合医疗所涉及的不同服务群体确定了一组合适的成本模型。在为目标个体分配适当资源时，发现个体发病负担必不可少。
