用两种基于索赔的措施预测患有痴呆症的医疗保险受益人的全因死亡率
Jianfang Liu1, Monica O'Reilly-Jacob1, Anyu Zhu2
1Columbia University School of Nursing, New York, NY, USA.
Medical care research and review : MCRR
|December 13, 2025
概括
慢性病症仓库 (CCW) 和埃利克沙瑟并发症指数预测痴呆症患者的死亡率具有相似的准确性. 弹性净回归为基于索赔的死亡率预测在这个人群中提供了一个强大的方法.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 预测痴呆症患者的死亡率对于医疗保健计划至关重要.
- 现有的并发症指数,如慢性病症仓库 (CCW) 和Elixhauser并发症指数,用于风险分层.
- 这些指数在预测患有痴呆症的医疗保险受益人死亡率方面的表现需要进一步进行比较.
研究的目的:
- 为了比较CCW和38条件Elixhauser并发症指数的预测性表现,在社区居住的痴呆症医疗保险受益人中对所有原因的死亡率进行比较.
- 评估弹性净物流回归在使用索赔数据开发低成本的死亡率预测模型中的实用性.
主要方法:
- 从2018年的索赔数据中确定了一个全国性样本,包括1,566,359名社区居住的痴呆症医疗保险受益者 (年龄≥65岁).
- 弹性净逻辑回归被用来模拟30天,60天,180天和1年的死亡率,利用30种CCW条件和38种Elixhauser并发症.
- 用C统计来评估歧视和校准措施的模型性能.
主要成果:
- 一年后的死亡率为19.0%.
- 无论是CCW和Elixhauser的测量都显示出良好的歧视 (C统计:0.696-0.731) 和校准.
- 在预测所有原因死亡率方面,在CCW和Elixhauser措施之间没有观察到显著的性能差异.
- 弹性净模型产生了节的预测指标,其性能与传统的物流回归可比.
结论:
- 慢性病症仓库和埃利克豪泽并发症指数在预测患有痴呆症的医疗保险受益人所有原因死亡率方面表现出类似的准确性.
- 弹性净物流回归为开发基于索赔的死亡率预测模型提供了强大而有效的方法.
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