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Health-based risk adjustment in Switzerland : an exploration using medical information from prior hospitalisation
Institut d'économie et management de la santé
Revised final version : Aug. 2004
Number of pages
Bibliogr. p. 121-126 Notes sur le titre : Research financed by the Swiss National Fund, National Research Program 45 "Future Problems of the Welfare State", Grant No. 4045-059720/1 Mention de responsabiblité : / Alberto Holly, Lucien Gardiol, Yves Eggli, Tarik Yalcin and Tiago Ribeiro SAPHIRID:44927
The aim of this study is to develop a prospective health-based risk adjustment model for sickness insurance funds in Switzerland which, in addition to age and gender, uses medical information from prior use of health care services. In fact, because information on ambulatory diagnoses is currently not available in Switzerland, we will limit our presentation to risk adjustment models which use diagnostic information from prior hospitalisation. [Authors, p. 9]. [Contents] 1. Introduction. 2. Risk selection and risk adjustment issues. 3. Risk adjustment: general considerations. 4. Econometric modelling. 5. The patient classification systems used in this study. 5.2 Patient classification systems based on AP-DRGs and SQLape. 6. Data and Method. 7. Development of a prospective health-based risk adjustment model: a preliminary. 7.1 Intermediary results for the one-year models. 7.1.1 Results for canton Vaud. 7.1.2 Results for the canton of Zurich. 7.1.3 OLS versus non-linear models. 8. Prospective health-based risk adjustment model. 9. Implementation of the proposed health-based risk adjustment model. 10. Future research.
Risk Adjustment , Insurance, Health , Insurance Selection Bias , Diagnosis-Related Groups , Models, Econometric
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