Propensity score matching - An illustrative analysis of dose response
Propensity score matching - An illustrative analysis of dose response
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DOI：
10.1097/01.mlr.0000089629.62884.22
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发表时间：
2003-10-01
期刊：
影响因子：
3
通讯作者：
Foster, EM
中科院分区：
文献类型：
--
作者：
Foster, EM
背景卫生服务研究人员通常对难以或不可能随机化的情况下的治疗或服务的效果感兴趣。一个有用的替代方法涉及倾向评分方法，这是一种基于一系列特征匹配不同群体成员的方法。在某些假设下，匹配组的比较揭示了利益治疗的影响。本文综述了倾向评分方法，并举例说明了它们在剂量反应分析中的应用，以及接受的服务量与治疗结果之间的关系。在精神卫生政策中，这个问题是平等等关键问题的核心。用于说明性分析的数据来自一项著名的儿童心理健康服务研究。该分析基于接受不同治疗剂量的个体的比较来估计门诊治疗的影响。使用倾向评分法对组间预先存在的观察到的差异进行了调整。该研究包括301名年龄在5至18岁之间的参与者，他们在研究中心接受治疗。分析的基础上的家庭特征和心理健康状况的儿童和青少年在采访中报告的父母以及行政数据的服务使用。使用倾向评分匹配的分析表明，增加服务可以改善治疗结果，特别是儿童功能。然而，至少对于所考虑的服务和结果，高水平治疗的边际效益是有限的。这些分析说明了潜在的价值倾向评分方法的卫生服务研究人员。
BACKGROUND. Health services researchers are often interested in the effect of a treatment or a service in situations in which randomization is difficult or impossible. One useful alternative involves propensity score methods, a means for matching members of different groups based on a range of characteristics. Under certain assumptions, comparisons of the matched groups reveal the impact of the treatment of interest.OBJECTIVES. This article reviews propensity score methods and illustrates their use in an analysis of dose response, the relationship between the volume of services receive, an treatment outcomes. In mental health policy, this question is central to key issues such as parity.RESEARCH DESIGN. Data for the illustrative analysis are taken from a well-known study of children's mental health services. This analysis estimates the impact of outpatient therapy based on comparisons of individuals receiving different treatment doses. Those comparisons are adjusted for preexisting observed differences among the groups using propensity score methods.SUBJECTS. The study includes 301 participants aged 5 to 18 years treated at the study sites.MEASURES. The analyses are based on family characteristics and the mental health status of children and adolescents reported in interviews with parents as well as administrative data on service use.RESULTS. Analyses using propensity score matching suggest that added services improve treatment outcomes, especially child functioning. However, at least for the services and outcomes considered, the marginal benefits to high levels of treatment are limited.CONCLUSIONS. These analyses illustrate the potential value of propensity score methods to health services researchers.