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Table 6 Prospective predictive ratios of alternate risk factors and different categories of expenditures.

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

Group

Mean expenditure

Demographics

ACGs

ADGs and demographics

ADGs, 19 EDCs and demographics

264 EDCs and demographics

Expenditure group by quintiles (prior classification: based on 2002)

0 - 20

276.2

3.915

1.427

1.359

1.374

1.617

20 - 40

1646.6

2.212

1.5

1.222

1.189

1.177

40 - 60

3737.7

1.573

1.455

1.3

1.181

1.122

60 - 80

8270

1.31

1.582

1.5

1.318

1.246

80 -100

51801.4

0.537

0.727

0.811

0.872

0.888

Expenditure group by quintiles (current classification: based on 2003)

0 - 20

233.2

52.474

29.365

28.362

27.018

28.393

20 - 40

1513.5

6.949

5.456

4.68

4.474

4.507

40 - 60

3571.8

3.187

3.093

2.76

2.492

2.424

60 - 80

8192.6

1.736

1.982

1.889

1.679

1.632

80 -100

59354.1

0.43

0.525

0.587

0.641

0.649

Morbidity burden (prior classification: based on 2002 morbidity level)

Non-user

3013.8

4.432

1.216

1.449

1.411

1.754

Very low

4081.3

2.483

1.046

0.636

0.837

1.032

Low

5746.9

1.775

0.95

0.879

0.968

1.022

Moderate

15844.5

1.019

1.002

1.05

1.003

0.983

High

34475.8

0.64

1.019

1.099

1.061

1.026

Very high

78192.9

0.429

1.012

0.922

0.984

0.985

Morbidity burden (current classification: based on 2003 morbidity level)

Non-user

8.2

1592.85

726.045

794.094

755.867

811.262

Very low

1651

6.124

4.273

3.597

3.473

3.641

Low

3965.4

2.571

2.143

1.87

1.798

1.826

Moderate

14477.2

1.125

1.165

1.183

1.168

1.152

High

38039.1

0.578

0.76

0.812

0.808

0.802

Very high

110996

0.301

0.439

0.48

0.529

0.539

Demographic group (sex and age group)

M, 0~18

6932

1.815

1.005

1.075

1.065

1.097

M, 18~34

7654

1.841

1.018

1.082

1.012

1.041

M, 35~49

11403

1.35

1.218

1.069

1.077

1.059

M, 50~64

24776.7

0.642

0.905

0.835

0.863

0.859

M, 65+

51787.1

0.386

0.672

0.761

0.85

0.901

F, 0~18

4976.6

2.554

1.38

1.478

1.401

1.409

F, 18~34

7948.9

1.799

1.228

1.392

1.252

1.171

F, 35~49

12074.5

1.253

1.348

1.223

1.125

1.074

F, 50~64

24265.9

0.664

1.054

0.998

1.003

0.973

F, 65+

43298.1

0.401

0.846

0.882

0.95

1.009

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