Risk-adjusted capitation payments: How well do principal inpatient diagnosis-based models work in the German situation? Results from a large data set

European Journal of Health Economics

Volumn 8, Issue 1, 2007, Pages 31-39

  Behrend, Corinne ^a,d   Buchner, Florian ^c   Happich, Michael ^a,d   Holle, Rolf ^a,d   Reitmeir, Peter ^a,d   Wasem, Jürgen ^b  

^a INSTITUTE OF EPIDEMIOLOGY   (Germany)

^b UNIVERSITY OF DUISBURG ESSEN   (Germany)

^c CARINTHIA UNIVERSITY OF APPLIED SCIENCES   (Austria)

^d Institute of Health Economics and Health Care Management   (Germany)

Author keywords

Germany; HCCs; Long term care; Risk adjustment

Indexed keywords

ADULT; AGED; ARTICLE; COST OF ILLNESS; DEMOGRAPHY; FEMALE; GERMANY; HEALTH CARE; HEALTH ECONOMICS; HIGH RISK POPULATION; HUMAN; MAJOR CLINICAL STUDY; MALE; PREDICTION; PRIORITY JOURNAL; RISK ASSESSMENT; RISK FACTOR; SOCIOECONOMICS;

ADOLESCENT; ADULT; AGE FACTORS; AGED; CAPITATION FEE; COMORBIDITY; DIAGNOSIS-RELATED GROUPS; FEMALE; GERMANY; HOSPITALIZATION; HUMANS; INTERNATIONAL CLASSIFICATION OF DISEASES; MALE; MIDDLE AGED; RISK ADJUSTMENT; SEX FACTORS; SOCIOECONOMIC FACTORS; YOUNG ADULT;

EID: 33847101375     PISSN: 16187598     EISSN: None     Source Type: Journal    
DOI: 10.1007/s10198-006-0004-7     Document Type: Article

References (8)

1. van de Ven, W.P.M.M., Ellis, R.: Risk adjustment in competitive health plan markets. In: Culyer, A.J., Newhouse, J.P. (eds.) Handbook of health economics, pp. 755-845. Elsevier North Holland, Amsterdam (2000)
2. Buchner, F., Wasem, J.: Needs for further improvement: risk adjustment in the German health insurance system. Health Policy 65(1), 21-35 (2003)
3. Deckenbach, B., et al.: Diagnose-basierte Risikoschätzmodelle für die Patientenklassifikation im vertragsärztlichen Vergütungssystem in Deutschland. Überprüfung der empirischen Anwendungsvoraussetzungen und exemplarische Analyse der Gruppierungsvorgä nge zur Beurteilung der Übertragbarkeit von ausgewählten medizinischen Klassifikationssystemen. Gutachten für die Kassenärztliche Bundesvereinigung. IGES, Berlin (2001)
4. Davison, A., Hinkley, D.: Bootstrap methods and their application. Cambdridge University Press, Cambridge (1997)
5. Cumming, R.B., et al.: A comparative analysis of claims-based methods of health risk assessment for commercial populations, p. 62. Park Nicollet Institute Health Research Center, Minneapolis (2002)
6. Duckett, S.J., Agius, P.: Performance of diagnosis-based risk adjustment measures in a population of sick Australians. Aust. N. Z. J. Public Health 26(6), 500-507 (2002)
7. Rosen, A., et al.: Evaluating diagnosis-baded case-mix measures: how well do they apply to the VA population?. Med. Care 39(7), 692-704 (2001)
8. Wasem, J., Lauterbach, K.W., Schräder, W.F.: Klassifikationsmodelle für Versicherte im morbiditätsorientierten Risikostrukturausgleich. G+G Wissenschaft. 5(2), 7-15 (2005)