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

Table 5 Concurrent predictive ratios of alternate risk factors and different categories of expenditures.

Group	Mean expenditure	Demographics	ACGs	ADGs and demographics	ADGs, 33 EDCs and demographics	264 EDCs and demographics
Expenditure group by quintiles (current classification: based on 2002)
0 - 20	267.1	44.127	5.384	6.667	6.034	7.587
20 - 40	1634.4	6.316	3.282	2.845	2.362	2.197
40 - 60	3739.1	2.941	2.439	2.359	1.92	1.742
60 - 80	2898.3	1.658	1.963	2.026	1.556	1.445
80 -100	57344	0.433	0.687	0.752	0.81	0.828
Morbidity burden (current classification: based on 2002 morbidity level)
Non-user	7.6	1688.88	0.924	186.889	170.046	254.982
Very low	1750.8	5.511	1.138	0.407	0.645	0.935
Low	4282	2.323	0.931	0.924	0.932	1.011
Moderate	13290.6	1.168	1.044	1.203	1.07	1.051
High	38526.2	0.561	0.948	1.108	0.991	0.954
Very High	106731.5	0.313	1.028	0.861	0.971	0.955
Demographic group (sex and age group)
M, 0~18	6312.9	1.982	1.01	1.077	0.981	1.043
M, 18~34	7037.6	1.9	0.949	1.097	1.016	0.997
M, 35~49	10971.9	1.344	1.135	1.058	1.006	0.976
M, 50~64	22590.3	0.679	0.928	0.911	0.975	0.973
M, 65+	50066.9	0.381	0.798	0.887	0.992	1.023
F, 0~18	6989	1.8	0.887	0.932	0.843	0.89
F, 18~34	8221.8	1.676	1.178	1.388	1.167	1.053
F, 35~49	11974.7	1.208	1.224	1.208	0.993	0.955
F, 50~64	22404.3	0.689	1.137	1.141	1.016	1.009
F, 65+	43574.6	0.384	0.931	0.974	1.031	1.052