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Capitation payment systems – risk factor estimation

Published: June 9, 2000
Category: Reports
Authors: Lo J, Tsai WD
Country: Taiwan
Language: Chinese (Mandarin)
Type: Care Management
Setting: Academic

Academia Economic Papers 28:231-261. Published in Chinese.

PURPOSE: To explore risk factors that can explain individual medical expenditure.

SAMPLE: Subjects included in “1996 NHI Satisfaction Survey” (N=5180).

METHOD: Concurrent model Four-part model (possibility of using services and total amount).

OUTCOME: 1996 annual medical expenditure

RESULT: Demographic factors, self-reported health status, objective health indicators, prior use & area-specific indicators of medical supply are all included in the model simultaneously to predict the outcome. It was found in the comprehensive model that: 1) Demographic factors could explain ambulatory expenditure but not inpatient expenditure. 2) Self-reported & objective health indicators only influenced the possibility of using ambulatory and inpatient service, respectively, but not expenditures. 3) Area-specific medical supply indicators did not influence ambulatory or inpatient expenditure. 4) Prior use is the most important factor in explaining both the possibility and total expenditure of using ambulatory and inpatient services.

Payment,Predictive Risk Modeling,Practice Patterns Comparison,Resource Use

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