EXPLORING THE INFLUENCE OF PROXIMITY TO DEATH ON DISEASE-SPECIFIC HOSPITAL EXPENDITURES: A CARPACCIO OF RED HERRINGS
EXPLORING THE INFLUENCE OF PROXIMITY TO DEATH ON DISEASE-SPECIFIC HOSPITAL EXPENDITURES: A CARPACCIO OF RED HERRINGS
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DOI：
10.1002/hec.1597
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发表时间：
2011-04-01
期刊：
影响因子：
2.1
通讯作者：
Polder, Johan J.
中科院分区：
文献类型：
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作者：
Wong, Albert;van Baal, Pieter H. M.;Polder, Johan J.
已经反复证明，死亡时间比年龄更能预测医疗保健支出。这就是所谓的“转移注意力”假说。在这篇文章中，我们调查这是否也是关于特定疾病的医院支出的情况。来自荷兰医院登记的纵向数据样本(n=11 253 455)被用来估计94个疾病特异性两部分模型。基于这些模型，蒙特卡罗模拟被用来评估死亡近似度和年龄对疾病特定支出的预测价值。结果显示，死亡的近在性对医疗费用有明显的影响。这种影响在大多数疾病中都存在，而且对大多数癌症来说最强。然而，即使对于一些不太致命的疾病，接近死亡也被发现是支出的一个重要预测因素。控制接近死亡，年龄被发现是大多数疾病支出的重要预测因素。然而，与濒临死亡相比，它的影响是温和的。考虑到每种疾病在接近死亡的程度和年龄方面的巨大差异，我们不仅可以把年龄说成是“红鲱鱼”，还可以把它说成是“红鲱鱼”。版权所有(C)2010 John Wiley&Sons，Ltd.
It has been demonstrated repeatedly that time to death is a much better predictor of health care expenditures than age. This is known as the 'red herring' hypothesis. In this article, we investigate whether this is also the case regarding disease-specific hospital expenditures. Longitudinal data samples from the Dutch hospital register (n = 11 253 455) were used to estimate 94 disease-specific two-part models. Based on these models, Monte Carlo simulations were used to assess the predictive value of proximity to death and age on disease-specific expenditures. Results revealed that there was a clear effect of proximity of death on health care expenditures. This effect was present for most diseases and was strongest for most cancers. However, even for some less fatal diseases, proximity to death was found to be an important predictor of expenditures. Controlling for proximity to death, age was found to be a significant predictor of expenditures for most diseases. However, its impact is modest when compared to proximity to death. Considering the large variation in the degree to which proximity to death and age matter for each specific disease, we may speak not only of age as a 'red herring' but also of a 'carpaccio of red herrings'. Copyright (C) 2010 John Wiley & Sons, Ltd.