Modeling Health Utilization of Medicaid Children

医疗补助儿童的健康利用建模

• 批准号: 6554906
• 负责人: David B Rein
• 金额: $ 2.96万
• 依托单位: GEORGIA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2004-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6554906
• 关键词: Medicare /Medicaid; child with disability; children; clinical research; cost effectiveness; developmental disease /disorder; health behavior; health care cost /financing; health care model; health care policy; health care quality; health care service organization; health care service utilization; health services research tag; human data; model design /development

DESCRIPTION (provided by applicant): Insurers, public health officials, providers, and health management professionals are interested in predicting who uses health care and why. The ability to predict who will use services is important for several practical applications, such as health care financing and targeting health promotion initiatives. Recent research suggests that better predictive estimates of individual level health care utilization are now possible. This research seeks to build a better model to predict the use of health services. Specifically, it seeks to predict the health care expenses for the full population of Georgia Medicaid children in 1999. This dissertation research combines the strengths of two leading cost forecasting models in order to address three primary goals: First, to build a better predictive model of health service utilization; Second, to address a particular health policy area, that of children with special health care needs (CSHCN), by providing information to help in their definition and categorization. Third, to build upon previous theory in health service utilization, such as the behavioral model of health service utilization and the principal agent model, using knowledge gained from new methodological approaches. To achieve these goals, a two-part model will be developed, with each portion of the model being treated as a finite mixture of at least two sub-populations. The model is estimated using maximum likelihood estimation, through use of the estimation/maximization (EM) algorithm. The new model is compared to published models to determine improvements in predictive power, using the BIC and the GOF criteria. Information from the new model can be used to design health care financing strategies for children in Medicaid; to identify different groups of CSHCN; and to expand the theory about who uses health services and why. The methodologies used to build this predictive model are directly applicable to several other areas of health services research.

描述（由申请人提供）：保险公司、公共卫生官员、提供者和健康管理专业人员对预测谁使用医疗保健及其原因感兴趣。预测谁将使用服务的能力对于若干实际应用很重要，例如卫生保健筹资和针对健康促进举措。最近的研究表明，现在有可能对个人水平的卫生保健利用进行更好的预测估计。

项目成果

A matter of classes: stratifying health care populations to produce better estimates of inpatient costs.

类别问题：对医疗保健人群进行分层，以更好地估计住院费用。

• DOI: 10.1111/j.1475-6773.2005.00393.x
• 发表时间: 2005
• 期刊: Health services research
• 影响因子: 3.4
• 作者: Rein,DavidB