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Volumn 56, Issue 6, 2008, Pages 1382-1392

Algorithmic prediction of health-care costs

Author keywords

Claims data; Health care: cost predictions; Prediction algorithms

Indexed keywords

ACCURATE PREDICTIONS; ALGORITHMIC PREDICTIONS; CLAIMS DATA; CLASSIFICATION TREES; COST DATUM; DATA-MINING; HEURISTIC RULES; MEDICAL INFORMATIONS; PREDICTION ALGORITHMS; PREDICTIVE MODELING; REGRESSION METHODS;

EID: 61549103139     PISSN: 0030364X     EISSN: 15265463     Source Type: Journal    
DOI: 10.1287/opre.1080.0619     Document Type: Article
Times cited : (171)

References (37)
  • 1
    • 0025802119 scopus 로고
    • The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip
    • Altman, R., G. Alarcón, D. Appelrouth, D. Bloch, D. Borenstein, K. Brandt, C. Brown, et al. 1991. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheumatism 34 505-514.
    • (1991) Arthritis Rheumatism , vol.34 , pp. 505-514
    • Altman, R.1    Alarcón, G.2    Appelrouth, D.3    Bloch, D.4    Borenstein, D.5    Brandt, K.6    Brown, C.7
  • 2
    • 0033785579 scopus 로고    scopus 로고
    • Using diagnoses to describe populations and predict costs-Capitated payment system uses demographic risk adjusted to calculate payments
    • Ash, A., R. P. Ellis, G. Pope, J. Ayanian, D. Bates, H. Burstin, L. Iezzoni, E. McKay, W. Yu. 2000. Using diagnoses to describe populations and predict costs-Capitated payment system uses demographic risk adjusted to calculate payments. Health Care Financial Rev. 21 7-28.
    • (2000) Health Care Financial Rev , vol.21 , pp. 7-28
    • Ash, A.1    Ellis, R.P.2    Pope, G.3    Ayanian, J.4    Bates, D.5    Burstin, H.6    Iezzoni, L.7    McKay, E.8    Yu, W.9
  • 5
    • 61549092862 scopus 로고    scopus 로고
    • Centers for Medicare & Medicaid Services: Diagnosis and Procedure Codes and Their Abbreviated Titles. 2004. Version 22, effective October 1. Retrieved August 28, 2006, http://www.cdc.gov/nchs/datawh.htm. #International%20Classification.
    • Centers for Medicare & Medicaid Services: Diagnosis and Procedure Codes and Their Abbreviated Titles. 2004. Version 22, effective October 1. Retrieved August 28, 2006, http://www.cdc.gov/nchs/datawh.htm. #International%20Classification.
  • 6
    • 33745253760 scopus 로고    scopus 로고
    • Use of diagnosis-based risk adjustment models to predict individual health care expenditure under the national health insurance system in Taiwan
    • Chang, R. E., C. L. Lai. 2005. Use of diagnosis-based risk adjustment models to predict individual health care expenditure under the national health insurance system in Taiwan. J. Formosan Med. Assoc. 104 883-890.
    • (2005) J. Formosan Med. Assoc , vol.104 , pp. 883-890
    • Chang, R.E.1    Lai, C.L.2
  • 8
    • 84868898240 scopus 로고    scopus 로고
    • Classification Rule with Unbiased Interaction Selection and Estimation
    • retrieved July 20, 2007
    • Classification Rule with Unbiased Interaction Selection and Estimation. Binaries retrieved July 20, 2007, http://www.stat.wisc.edu/loh/ cruise.html.
    • Binaries
  • 10
    • 0027745581 scopus 로고
    • Looking for answers in all the wrong places
    • Dans, P. 1993. Looking for answers in all the wrong places. Ann. Internal Med. 119 855-857.
    • (1993) Ann. Internal Med , vol.119 , pp. 855-857
    • Dans, P.1
  • 11
    • 0037950542 scopus 로고    scopus 로고
    • A prediction model for targeting low-cost, high-risk members of managed care organizations
    • Dove, H., I. Duncan, A. Robb. 2003. A prediction model for targeting low-cost, high-risk members of managed care organizations. Amer. J. Managed Care 9 381-389.
    • (2003) Amer. J. Managed Care , vol.9 , pp. 381-389
    • Dove, H.1    Duncan, I.2    Robb, A.3
  • 13
    • 32944479755 scopus 로고    scopus 로고
    • A comparison of comorbidity measurements to predict healthcare expenditures
    • Farley, J. F., C. R. Harley, J. W. Devine. 2006. A comparison of comorbidity measurements to predict healthcare expenditures. Amer. J. Managed Care 12 110-117.
    • (2006) Amer. J. Managed Care , vol.12 , pp. 110-117
    • Farley, J.F.1    Harley, C.R.2    Devine, J.W.3
  • 14
    • 33646798449 scopus 로고    scopus 로고
    • Using the SF-12 health status measure to predict medical expenditures
    • Fleishman, J. A., J. W. Cohen, W. G. Manning, M. Kosinksi. 2006. Using the SF-12 health status measure to predict medical expenditures. Med. Care 44 I-54-I-63.
    • (2006) Med. Care , vol.44
    • Fleishman, J.A.1    Cohen, J.W.2    Manning, W.G.3    Kosinksi, M.4
  • 15
    • 0027741083 scopus 로고
    • Discordance of databases designed for claims payment versus clinical information systems: Implications for outcomes research
    • Jolins, J., M. Ancukiewicz, E. DeLong, D. Pryor, L. Muhlbaier, D. Mark. 1993. Discordance of databases designed for claims payment versus clinical information systems: Implications for outcomes research. Ann. Internal Med. 119 844-850.
    • (1993) Ann. Internal Med , vol.119 , pp. 844-850
    • Jolins, J.1    Ancukiewicz, M.2    DeLong, E.3    Pryor, D.4    Muhlbaier, L.5    Mark, D.6
  • 16
    • 77956763016 scopus 로고    scopus 로고
    • Health econometrics
    • A. J. Culyer, J. P. Newhouse, eds, Elsevier, Amsterdam
    • Jones, A. M. 2000. Health econometrics. A. J. Culyer, J. P. Newhouse, eds. Handbook in Health Economics. Elsevier, Amsterdam, 265-344.
    • (2000) Handbook in Health Economics , pp. 265-344
    • Jones, A.M.1
  • 17
    • 4243128193 scopus 로고    scopus 로고
    • On clusterings: Good, bad and spectral
    • Kannan, R., S. Vempala, A. Vetta. 2004. On clusterings: Good, bad and spectral. J. ACM 51 497-515.
    • (2004) J. ACM , vol.51 , pp. 497-515
    • Kannan, R.1    Vempala, S.2    Vetta, A.3
  • 18
    • 1542573450 scopus 로고    scopus 로고
    • Classification trees with unbiased multiway splits
    • Kim, H., W.-Y. Loh. 2001. Classification trees with unbiased multiway splits. J. Amer. Statist. Assoc. 96 589-604.
    • (2001) J. Amer. Statist. Assoc , vol.96 , pp. 589-604
    • Kim, H.1    Loh, W.-Y.2
  • 19
    • 0141907311 scopus 로고    scopus 로고
    • Classification trees with bivariate linear discriminant node models
    • Kim, H., W.-Y. Loh. 2003. Classification trees with bivariate linear discriminant node models. J. Comput. Graphical Statist. 12 512-530.
    • (2003) J. Comput. Graphical Statist , vol.12 , pp. 512-530
    • Kim, H.1    Loh, W.-Y.2
  • 20
    • 0036677013 scopus 로고    scopus 로고
    • Assessing comorbidity using claims data-An overview
    • Klabunde, C. N., J. L. Warren, J. M. Legier. 2002. Assessing comorbidity using claims data-An overview. Med. Care 40 26-35.
    • (2002) Med. Care , vol.40 , pp. 26-35
    • Klabunde, C.N.1    Warren, J.L.2    Legier, J.M.3
  • 21
    • 0003557770 scopus 로고
    • An application of logistic regression methods to survey data: Predicting high cost users of medical care
    • American Statistical Association. Retrieved August 28, 2006
    • LaVange, L. M., V. G. Iannacchione, S. A. Garfinkel. 1986. An application of logistic regression methods to survey data: Predicting high cost users of medical care. Proc. Survey Research Methods Section, American Statistical Association. Retrieved August 28, 2006, http://www.amstat.org/sections/SRMS/ proceedings/papers/1986-049.pdf.
    • (1986) Proc. Survey Research Methods Section
    • LaVange, L.M.1    Iannacchione, V.G.2    Garfinkel, S.A.3
  • 22
    • 0034243918 scopus 로고    scopus 로고
    • Lawthers, A. G., E. P. McCarthy, R. B. Davis, L. E. Peterson, R. H. Palmers, L. I. lezzoni. 2000. Identification of in-hospital complications from claims data. Is it valid? Med. Care 38 785-793.
    • Lawthers, A. G., E. P. McCarthy, R. B. Davis, L. E. Peterson, R. H. Palmers, L. I. lezzoni. 2000. Identification of in-hospital complications from claims data. Is it valid? Med. Care 38 785-793.
  • 23
    • 0031312210 scopus 로고    scopus 로고
    • Split selection methods for classification trees
    • Loh, W.-Y., Y.-S. Shih. 1997. Split selection methods for classification trees. Statistka. Sinica 7 815-840.
    • (1997) Statistka. Sinica , vol.7 , pp. 815-840
    • Loh, W.-Y.1    Shih, Y.-S.2
  • 24
    • 0034993174 scopus 로고    scopus 로고
    • Estimating log models: To transform, or not to transform?
    • Manning, W. G., J. Mullahy. 2001. Estimating log models: To transform, or not to transform? J. Health Econom. 20 461-494.
    • (2001) J. Health Econom , vol.20 , pp. 461-494
    • Manning, W.G.1    Mullahy, J.2
  • 26
    • 0033051752 scopus 로고    scopus 로고
    • Determining an episode of care using claims data: Diabetic foot ulcer
    • Mehta, S., H. Glick, S. Suzuki, K. Schulman. 1999. Determining an episode of care using claims data: Diabetic foot ulcer. Diabetes Care 22 1110-1115.
    • (1999) Diabetes Care , vol.22 , pp. 1110-1115
    • Mehta, S.1    Glick, H.2    Suzuki, S.3    Schulman, K.4
  • 27
    • 84868906673 scopus 로고    scopus 로고
    • National Drug Code Directory, Retrieved August 28, 2006
    • National Drug Code Directory. 2004. List of FDA approved drugs as of December 3.1, 2004. Retrieved August 28, 2006, http://www.fda.gov/cder/ndc/ database/default.htm.
    • (2004) List of FDA approved drugs as of December 3.1, 2004
  • 28
    • 6344263679 scopus 로고    scopus 로고
    • Predicting healthcare costs in a population of Veterans Affairs beneficiaries using diagnosis-based risk adjustment and self-reported health status
    • Pietz, K., C. M. Ashton, M. McDonell, N. P. Wray. 2004. Predicting healthcare costs in a population of Veterans Affairs beneficiaries using diagnosis-based risk adjustment and self-reported health status. Med. Care 42 1027-1035.
    • (2004) Med. Care , vol.42 , pp. 1027-1035
    • Pietz, K.1    Ashton, C.M.2    McDonell, M.3    Wray, N.P.4
  • 29
    • 9444241529 scopus 로고    scopus 로고
    • Clinical outcomes and adherence to medications measured by claims data in patients with diabetes
    • Pladevall, M. 2004. Clinical outcomes and adherence to medications measured by claims data in patients with diabetes. Diabetes Care 27 2800-2805.
    • (2004) Diabetes Care , vol.27 , pp. 2800-2805
    • Pladevall, M.1
  • 30
    • 27744464918 scopus 로고    scopus 로고
    • Predictive modeling of total healthcare costs using pharmacy claims data: A comparison of alternative econometric cost modeling techniques
    • Powers, C. A., C. M. Meyer, M. C. Roebuck, B. Vaziri. 2005. Predictive modeling of total healthcare costs using pharmacy claims data: A comparison of alternative econometric cost modeling techniques. Med. Care 43 1065-1072.
    • (2005) Med. Care , vol.43 , pp. 1065-1072
    • Powers, C.A.1    Meyer, C.M.2    Roebuck, M.C.3    Vaziri, B.4
  • 32
    • 77956769711 scopus 로고    scopus 로고
    • Risk adjustment in competitive health plan markets
    • A. J. Culyer, J. P. Newhouse, eds, Elsevier, Amsterdam
    • Van de Ven, W. P. M. M., R. P. Ellis. 2000. Risk adjustment in competitive health plan markets. A. J. Culyer, J. P. Newhouse, eds. Handbook in Health Economics. Elsevier, Amsterdam, 756-845.
    • (2000) Handbook in Health Economics , pp. 756-845
    • Van de Ven, W.P.M.M.1    Ellis, R.P.2
  • 34
    • 80255140593 scopus 로고
    • Use of claims data systems to evaluate health care outcomes. Mortality and reoperation following prostatectomy
    • Wennberg, J., N. Roos, L. Sola, A. Schori, R. Jaffe. 1987. Use of claims data systems to evaluate health care outcomes. Mortality and reoperation following prostatectomy. J. American Med. Assoc. 257 933-936.
    • (1987) J. American Med. Assoc , vol.257 , pp. 933-936
    • Wennberg, J.1    Roos, N.2    Sola, L.3    Schori, A.4    Jaffe, R.5
  • 35
    • 12344259418 scopus 로고    scopus 로고
    • Predicting pharmacy costs and other medical costs using diagnoses and drug claims
    • Zhao, Y., A. S. Ash, R. P. Ellis, J. Z. Ayanian, G. C. Pope, B. Bowen, L. Weyuker. 2005. Predicting pharmacy costs and other medical costs using diagnoses and drug claims. Med. Care 43 34-43.
    • (2005) Med. Care , vol.43 , pp. 34-43
    • Zhao, Y.1    Ash, A.S.2    Ellis, R.P.3    Ayanian, J.Z.4    Pope, G.C.5    Bowen, B.6    Weyuker, L.7
  • 37
    • 0030764819 scopus 로고    scopus 로고
    • Methods for comparison of cost data
    • Zhou, Z. H., C. A. Melfi, S. L. Hui. 1997. Methods for comparison of cost data. Ami. Internal Med. 127 752-756.
    • (1997) Ami. Internal Med , vol.127 , pp. 752-756
    • Zhou, Z.H.1    Melfi, C.A.2    Hui, S.L.3


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