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Table 2 Concurrent adjusted R-squared and mean absolute prediction error of alternate risk factors and different categories of expenditure.

From: An in-depth assessment of a diagnosis-based risk adjustment model based on national health insurance claims: the application of the Johns Hopkins Adjusted Clinical Group case-mix system in Taiwan

 

Total expenditure

Type of expenditure

Source of expenditure

  

Medical

Pharmacy

Inpatient

Outpatient

R 2 : (1) raw expenditure

     

Demographics-only

0.0421

0.0305

0.0266

0.0132

0.0477

ACGs

0.1486

0.1319

0.0597

0.0894

0.1107

ADGs and demographics

0.1709

0.1435

0.0848

0.0976

0.1342

ADGs, 33 EDCs and demographics

0.3895

0.3938

0.155

0.3053

0.3156

264 EDCs and demographics

0.3972

0.3993

0.1638

0.3191

0.3216

R 2 : (2) expenditure truncated at 2 standard deviations above mean of log (expenditure+1)

Truncated criterion

595,431

339,360

86,013

262,810

449,657

% of truncated cases

0.24%

0.33%

0.32%

0.33%

0.15%

Demographics-only

0.0701

0.0545

0.1664

0.0299

0.0855

ACGs

0.2275

0.2265

0.3012

0.1753

0.1935

ADGs and demographics

0.2599

0.2523

0.3843

0.1919

0.2323

ADGs, 33 EDCs and demographics

0.4825

0.4492

0.4738

0.3643

0.4321

264 EDCs and demographics

0.4969

0.4695

0.5238

0.3994

0.4409

R 2 : (3) expenditure truncated at top 0.5%

     

Truncated criterion

333,235

250,144

70,948

193,296

115,412

% of truncated cases

0.47%

0.48%

0.44%

0.51%

0.45%

Demographics-only

0.0963

0.0629

0.1785

0.0323

0.1836

ACGs

0.298

0.2576

0.3162

0.1845

0.402

ADGs and demographics

0.3419

0.2873

0.4032

0.2051

0.4767

ADGs, 33 EDCs and demographics

0.517

0.4618

0.4855

0.3626

0.5539

264 EDCs and demographics

0.5414

0.488

0.5377

0.4021

0.588

Mean absolute prediction error: raw expenditure

     

Demographics-only

109.19%

118.23%

111.02%

174.62%

94.09%

ACGs

86.72%

94.69%

93.40%

144.80%

74.21%

ADGs and demographics

94.42%

105.85%

95.91%

164.70%

75.33%

ADGs, 33 EDCs and demographics

77.93%

86.17%

87.61%

133.71%

68.89%

264 EDCs and demographics

77.57%

87.51%

83.40%

133.32%

68.34%

  1. Number in study sample (validation only): 51,970
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BMC Medicine

ISSN: 1741-7015

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