Predictability of drug expenditures: an application using morbidity data
利用加泰罗尼亚地区2002-2003年的个人人口统计和发病率数据，评估不同模型预测未来药品支出的能力，发现基于临床风险分组的风险调整方法具有高预测力，对设定药品福利保费有参考价值。
The growth of pharmaceutical expenditure and its prediction is a major concern for policymakers and healthcare managers. This paper explores different predictive models to estimate future drug expenses, using demographic and morbidity individual information from an integrated healthcare delivery organization in Catalonia for years 2002 and 2003. The morbidity information consists of codified health encounters grouped through the Clinical Risk Groups (CRGs). We estimate pharmaceutical costs using several model specifications, and CRGs as risk adjusters, providing an alternative way of obtaining high predictive power comparable to other estimations of drug expenditures in the literature. These results have clear implications for the use of risk adjustment and CRGs in setting the premiums for pharmaceutical benefits.