Adjusting capitation using chronic disease risk factors: A preliminary study

نویسندگان

  • Jonathan Howland
  • Joseph Stokes
  • Stephen C. Crane
  • Albert J. Belanger
چکیده

Researchers have sought ways to modify Medicare's capitation formula, the adjusted average per capita cost (AAPCC), by including measures of individual health status. The present study assesses the value of risk factors for disease as predictors of hospitalization for Framingham Heart Study participants (1,210 males and 1,496 females) 60-65 years of age. Regression models including several common physiologic measures and prior hospitalizations yielded adjusted R2s of 9.69 percent for males and 3.61 percent for females. The contributions of the risk factors and prior hospitalization were about equal and independent. These results confirm the potential utility of disease risk factors for adjusting the AAPCC.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Weight of Risk Factors for Adjusting Capitation in Primary Health Care: A Systematic Review

Background: Capitation payment is the best-known strategy for paying providers in primary health care. Since health care needs and personal characteristics play an essential role in health care utilization and resource spending, there is a growing tendency on risk adjustment models among health researchers.  The objective of this systematic review was to examine the weights used for risk adjust...

متن کامل

Using chronic disease risk factors to adjust Medicare capitation payments

This study evaluates the use of risk factors for chronic disease as health status adjusters for Medicare's capitation formula, the average adjusted per capita costs (AAPCC). Risk factor data for the surviving members of the Framingham Study cohort who were examined in 1982-83 were merged with 100 percent Medicare payment data for 1984 and 1985, matching on Social Security number and sex. Seven ...

متن کامل

Risk Adjustment for a Children's Capitation Rate

Few capitation arrangements vary premiums by a child's health characteristics, yielding an incentive to discriminate against children with predictably high expenditures from chronic diseases. In this article, we explore risk adjusters for the 35 percent of the variance in annual out-patient expenditure we find to be potentially predictable. Demographic factors such as age and gender only explai...

متن کامل

An evaluation of gender equity in different models of primary care practices in Ontario

BACKGROUND The World Health Organization calls for more work evaluating the effect of health care reforms on gender equity in developed countries. We performed this evaluation in Ontario, Canada where primary care models resulting from reforms co-exist. METHODS This cross sectional study of primary care practices uses data collected in 2005-2006. Healthcare service models included in the stud...

متن کامل

Comparison of primary care models in the prevention of cardiovascular disease - a cross sectional study

BACKGROUND Primary care providers play an important role in preventing and managing cardiovascular disease. This study compared the quality of preventive cardiovascular care delivery amongst different primary care models. METHODS This is a secondary analysis of a larger randomized control trial, known as the Improved Delivery of Cardiovascular Care (IDOCC) through Outreach Facilitation. Using...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 9  شماره 

صفحات  -

تاریخ انتشار 1987