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Health expenditure estimation and functional form: applications of the generalized gamma and extended estimating equations models.
- Source :
-
Health economics [Health Econ] 2010 May; Vol. 19 (5), pp. 608-27. - Publication Year :
- 2010
-
Abstract
- Health-care expenditure regressions are used in a wide variety of economic analyses including risk adjustment and program and treatment evaluations. Recent articles demonstrated that generalized gamma models (GGMs) and extended estimating equations (EEE) models provide flexible approaches to deal with a variety of data problems encountered in expenditure estimation. To date there have been few empirical applications of these models to expenditures. We use data from the US Medical Expenditure Panel Survey to compare the bias, predictive accuracy, and marginal effects of GGM and EEE models with other commonly used regression models in a cross-validation study design. Health-care expenditure distributions vary in the degree of heteroskedasticity, skewness, and kurtosis by type of service and population. To examine the ability of estimators to address a range of data problems, we estimate models of total health expenditures and prescription drug expenditures for two populations, the elderly and privately insured adults. Our findings illustrate the need for researchers to examine their assumptions about link functions: the appropriate link function varies across our four distributions. The EEE model, which has a flexible link function, is a robust estimator that performs as well, or better, than the other models in each distribution.
- Subjects :
- Adolescent
Adult
Aged
Bias
Chronic Disease
Costs and Cost Analysis
Data Interpretation, Statistical
Female
Health Benefit Plans, Employee statistics & numerical data
Humans
Linear Models
Male
Medicare statistics & numerical data
Middle Aged
Models, Economic
United States
Young Adult
Health Benefit Plans, Employee economics
Health Expenditures statistics & numerical data
Medicare economics
Prescription Drugs economics
Subjects
Details
- Language :
- English
- ISSN :
- 1099-1050
- Volume :
- 19
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Health economics
- Publication Type :
- Academic Journal
- Accession number :
- 19434646
- Full Text :
- https://doi.org/10.1002/hec.1498