美国晚年医疗保健支出的预测模型
Liran Einav1,2, Amy Finkelstein3,4, Sendhil Mullainathan1,5
1National Bureau of Economic Research, Cambridge, MA 02138, USA.
概括
医疗保险在生命末期的支出并不一定是浪费的. 不论病患是否能康复或死亡, 医疗费用往往很高,
科学领域:
- 健康经济学
- 生物统计学
- 老年学
背景情况:
- 医疗保险支出的很大一部分发生在生命的最后一年.
- 这种支出模式往往被误解为浪费,
研究的目的:
- 根据预测死亡风险分析医疗保险支出分配.
- 挑战使用终止的消费本身就是浪费.
主要方法:
- 开发了一种使用医疗保险索赔预测年死亡风险的机器学习模型.
- 分析了医疗保健支出与预测死亡率的分布.
主要成果:
- 死亡高度不可预测;5%的支出用于预测死亡风险高于50%的个人.
- 不管病人的生存情况如何, 增加的医疗费用解释了近乎死亡的30-50%的医疗费用.
- 对于死者 (后期) 的支出并不等同于对"无望者" (前期) 的支出.
结论:
- 医疗保险在临近死亡时所花费的大量资金部分归因于对慢性病患者的照顾,
- 需要考虑疾病的严重程度和不可预测的死亡率.
- 目前对医疗保险支出的解释可能会忽视患者健康状况的复杂性.
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