Core--Forecasts and Changes in Health and Illness Costs

核心——健康和疾病成本的预测和变化

• 批准号: 6335317
• 负责人: P.J. ERIC STALLARD
• 金额: $ 14.57万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-05-01 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6335317
• 关键词: Medicare /Medicaid; behavioral /social science research tag; biomedical facility; computer simulation; health care cost /financing; human data; human old age (65+); model design /development; prognosis

This core will support the production of computer based forecasts and simulations of changes in the health and functioning of the U.S. elderly population and estimate the cost differentials associated with changes in those forecasts due to the use of different assumptions. The empirical basis of these forecasts will initially be the changes in functional status and dimensions and mortality assessed in the 1982, 1984, 1989, 1994, and 1999 NLTCS. The model is designed so that the parameters of the health process can be made functions of different types of non-health inputs generated by modeling effects in various of the specific research projects. Thus, models of economic effects on health will be generated in Projects 2, 3 and 4. Project 1 will deal with the methodological issues involved in constructing the mathematical interfaces of the health forecasting model with the other models developed, and empirically calibrated, in the various projects. One of the major issues to be dealt with in the sub-projects is how research investment relates to the rate of adoption, and efficacy of, clinical innovations. There is relatively little direct data on this relation, That is, it is possible to derive estimates of the amount spent on specific types of research, to derive estimates of the amount spent on purchasing specific clinical services made possible by that research, and to derive estimates of how much health is changed by various levels of health spending. There is little data directly relating research investments to changes in health for specific individuals however. Thus, we propose to use the available data and link in a mathematically consistent structure with inputs from experts on biomedical research and from experts on the clinical application of specific technologies. We will examine the sensitivity of health outcomes to such investments taking account of the evident degree of stochastic and construct uncertainty. That effort will help in identifying types and sources of additional evidence that may help to resolve some of this uncertainty.

该核心将支持基于计算机的预测和模拟美国老年人群健康和功能的变化，并估计由于使用不同假设而导致的预测变化相关的成本差异。这些预测的经验基础最初是在1982，1984，1989，1994和1999 NLTC中评估的功能状态，维度和死亡率的变化。该模型的设计是为了使健康过程的参数可以成为不同类型的非健康输入的功能，该功能是通过在各个特定研究项目中建模效应而产生的。因此，项目2，项目1将产生对健康的经济影响模型。项目1将处理构建健康预测模型的数学界面的方法论问题，并在各种项目中开发并经过经验校准的其他模型。次项目中要解决的主要问题之一是研究投资与临床创新的采用率和功效如何相关。关于这种关系的直接数据相对较少，也就是说，可以得出对特定类型研究的数量的估计，以得出该研究所能获得的购买特定临床服务所花费的数量的估计，并得出对各种健康级别的健康支出更改健康的估计。但是，很少有数据将研究投资与特定个人的健康变化联系起来。因此，我们建议使用可用的数据，并在数学一致的结构中与生物医学研究专家的意见以及特定技术的临床应用专家的意见。我们将研究健康成果对此类投资的敏感性，以考虑到随机性和构建不确定性的明显程度。这项努力将有助于确定可能有助于解决某些不确定性的其他证据的类型和来源。