Work detail

Cost Analysis of Health Care of Outpatient Providers Employing Risk-adjustment

Author: Mgr. Pavlína Jandová
Year: 2015 - summer
Leaders: Mgr. Henrieta Tulejová M.S.
Consultants:
Work type: EEI & EP
Masters
Language: English
Pages: 66
Awards and prizes:
Link: https://is.cuni.cz/webapps/zzp/detail/138416/
Abstract: The aim of this thesis is to investigate ways of assessing economic efficiency of outpatient health
care providers. It analyzes feasibility of employment of risk-adjustment and profiling in the Czech
Republic using administrative data reported to health insurance company in the field of
otorhinolaryngology.
First, the thesis provides an overview of economic profiling methods. Out of these, indirect
standardization of costs with risk-adjustment on patient level was used in the empirical part.
Next, methods addressing specific problems of health care data (in particular, skewness, excess of
zero values and non-negativity) are explored. Using OLS on logarithms on positive part of the
distribution, three representations of costs were estimated, based on selected risk-factors. Several
patient factors proved significant in final models (specifically, age, gender, number of
hospitalizations, region of residence and chronic conditions asthma, COPD and depression),
however, the quality of the model is extremely poor. Reasons for dissatisfactory fit of models are
various. We conclude that data-selection process is not appropriate to perform economic
comparison. And care of outpatient otorhinolaryngology is extremely specific to be captured by
information provided. Still, profiling of providers is performed to provide an illustrative case.

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