美国流行多重疾病组合的医疗保健支出中的种族差异:一个横截面研究
Manal Alshakhs1, Patricia J Goedecke2, James E Bailey3
1Health Outcomes and Policy Program, University of Tennessee Health Science Center, Memphis, TN, USA.
BMC medicine
|October 22, 2023
概括
医疗保健成本模型显示了显著的种族差异,非洲裔美国人承担的费用最高,西班牙裔美国人最低. 需要改进的模型,以准确地反映不同人群的成本.
科学领域:
- 卫生经济学 卫生经济学
- 生物统计学 生物统计学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 模拟美国流行多病症组合的总医疗费用.
- 评估跨多元种族和种族人口的模型准确性.
研究的目的:
- 开发和评估用于预测与常见多病症组合相关的总医疗费用模型.
- 分析不同种族/族群和年龄组的成本变化和模型性能.
主要方法:
- 使用Cerner HealthFacts数据 (2016-2017年) 针对45岁以上的患者.
- 应用了具有马分布和日志链接功能的通用线性模型 (GLM).
- 纳入人口统计,BMI,医院和人口普查部门数据进行模型调整.
主要成果:
- 非洲裔美国人呈现出最高的总费用,而西班牙裔在两个年龄组中都有最低的费用.
- 模型的准确性因种族/种族而异,对某些群体的估计过高 (例如,患有心脏病的白人) 和对其他群体的估计低 (例如,患有肥胖的西班牙裔).
- 种族,特别是非裔美国人,是医疗保健成本上升的强有力的预测因素.
结论:
- 当前的成本模型在跨不同种族和民族群体应用时显示出显著的不准确性.
- 未来的成本建模应纳入多病症类型,种族/种族以及年龄/肥胖状态,以提高准确性和公平性.
- 这些发现强调了需要更强大的医疗保健成本模型,以确保公平的服务供应.
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