Performance of diagnosis‐based risk adjustment measures in a population of sick Australians

Duckett, Stephen; Agius, Paul A.

doi:10.1111/j.1467-842x.2002.tb00356.x

Cited by 11 publications

(17 citation statements)

References 16 publications

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“…Duckett and Agius . Based on in-patient diagnostic information, age, gender, socio-economic status and HCCs explained around 46% of variation in concurrent-year log-transformed expenditures [6]. With prospective (subsequent) year modelling, explanatory power was weaker, explaining about 18% of the variation in the total log-transformed expenditures.…”

Section: Discussion Of Findingsmentioning

confidence: 99%

Risk-adjusted capitation payments: how well do principal inpatient diagnosis-based models work in the German situation? Results from a large data set

et al. 2007

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Section: Discussion Of Findingsmentioning

confidence: 99%

Risk-adjusted capitation payments: how well do principal inpatient diagnosis-based models work in the German situation? Results from a large data set

et al. 2007

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“…The articles included descriptions on risk adjustment methods in several countries, e.g. Germany [3456], Australia [78910], Switzerland [1112], Hungary [13], USA (Medicare [1415161718192021], Medicaid [22232425], Veterans Affairs [262728293031]), Spain [3233], Sweden [343536], Canada [373839], The Netherlands [40414243], Taiwan [44454647], Chile [4849], Israel [4250], Great Britain [41], Italy [51], Poland [52], and Bulgaria [53]. …”

Section: Resultsmentioning

confidence: 99%

A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

Juhnke

Bethge

Mühlbacher

2016

International Journal of Integrated Care

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Introduction:Effective risk adjustment is an aspect that is more and more given weight on the background of competitive health insurance systems and vital healthcare systems.The objective of this review was to obtain an overview of existing models of risk adjustment as well as on crucial weights in risk adjustment. Moreover, the predictive performance of selected methods in international healthcare systems should be analysed.Theory and methods:A comprehensive, systematic literature review on methods of risk adjustment was conducted in terms of an encompassing, interdisciplinary examination of the related disciplines.Results:In general, several distinctions can be made: in terms of risk horizons, in terms of risk factors or in terms of the combination of indicators included. Within these, another differentiation by three levels seems reasonable: methods based on mortality risks, methods based on morbidity risks as well as those based on information on (self-reported) health status.Conclusions and discussion:After the final examination of different methods of risk adjustment it was shown that the methodology used to adjust risks varies. The models differ greatly in terms of their included morbidity indicators. The findings of this review can be used in the evaluation of integrated healthcare delivery systems and can be integrated into quality- and patient-oriented reimbursement of care providers in the design of healthcare contracts.

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“…These findings give a better understanding of primary care patterns of use and expenditures; the low persistence of high use may partly explain why risk adjustment methods still have difficulties to predict the future costs generated by a given patient even in the short run, as shown by the relatively modest predictive power of adjustment methods such as ADGs and ACGs [18][19][20]. Until now, more efforts have been made to estimate inter-individual variations and their predictive power than to predict intra-individual variations over time and their impact at the group level.…”

Section: Discussionmentioning

confidence: 99%

The predictability of individual primary care costs and its impact on managed care plans

Demers

2004

Health Policy

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Performance of diagnosis‐based risk adjustment measures in a population of sick Australians

Abstract: Objective: Australia is beginning to explore 'managed competition' as an organising framework for the health care system. This requires setting fair capitation rates, i.e.rates that adjust for the risk profile of covered lives. This paper tests two

Cited by 11 publications

References 16 publications

Risk-adjusted capitation payments: how well do principal inpatient diagnosis-based models work in the German situation? Results from a large data set

Risk-adjusted capitation payments: how well do principal inpatient diagnosis-based models work in the German situation? Results from a large data set

A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

The predictability of individual primary care costs and its impact on managed care plans

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