Diagnostics for checking the gamma distribution assumption in generalized linear models used for modeling health care costs

Abstract Objectives Evidence suggests that gout is associated with high health care costs and that many inpatient admissions are preventable. Understanding the drivers of health care costs in patients with gout will allow more targeted intervention. The objective was to examine factors associated with high health service utilisation and costs in patients admitted to hospital with gout. Methods Hospital and emergency department data was obtained for patients who had been admitted to hospital with a diagnosis of gout for the first time between 2002 and 2009. The total number, cost and potentially preventable events for the follow-up period was calculated for up to five years post the initial gout hospitalisation. The association between patient characteristics with health service utilisation and health care costs was examined using generalised linear models. Results The cohort included 4,379 individuals, that had 22,222 ED attendances (median cost: $1,826 per patient, IQR: $433 - $4,414), and 58,920 hospital admissions (median cost: $25,009 per patient, IQR: $6,844 - $60,535). Gout was not a primary driver of ED attendances or hospitalisations. A history of smoking and comorbidities including cardiovascular disease, diabetes and mental health disorders were associated with an increase health service utilisation and costs. Conclusion The presence of comorbidities play an important role the risk of health service utilization in people with gout and represents an opportunity to both improve the health-related outcomes for these patients and reduce re-presentations and associated health care costs for the health care system.

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Health Care Costs Associated with Ankylosing Spondylitis in Turkey: An Analysis from Nationwide Real-World Data

International Journal of Rheumatology ◽

10.1155/2013/139608 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Onur Baser ◽

Abdulkadir Burkan ◽

Erdem Baser ◽

Rasim Koselerli ◽

Emre Ertugay ◽

...

Keyword(s):

Health Care ◽

Ankylosing Spondylitis ◽

Health Care Costs ◽

Linear Models ◽

Office Visit ◽

Real World Data ◽

Treatment Type ◽

Comorbidity Scores ◽

Incident Cases ◽

Care Costs

Objectives. To explore health care costs associated with ankylosing spondylitis (AS) in Turkey.Methods. Research-identified data from a system that processes claims for all Turkish health insurance funds were analyzed. Adult prevalent and incident AS patients with two AS visits at least 60 days apart, identified between June 1, 2010 and December 31, 2010, with at least 1 year of continuous health plan enrollment for the baseline and follow-up years were included in the study. Pharmacy, outpatient, and inpatient claims were compiled over the study period for the selected patients. Generalized linear models were used to estimate the expected annual costs, controlling for baseline demographic and clinical characteristics.Results. A total of 2.986 patients were identified, of which 603 were incident cases and 2.383 prevalent cases. The mean ages were 39 and 41 years, respectively, and 44% and 38% were women for incident and prevalent cases. Prevalent patients had higher comorbidity scores (5.01 versus 2.24,P<0.001) and were more likely to be prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) (77% versus 72%,P<0.001) or biologics (35% versus 8%,P<0.006) relative to incident patients. Seventy-seven percent of prevalent patients were prescribed NSAIDs, followed by biologic and disease-modifying antirheumatic drugs (DMARDs). Total annual medical costs for incident AS patients were €2.253 and €4.233 for prevalent patients. Pharmacy costs accounted for a significant portion of total costs (88% for prevalent patient, 77% for incident patient), followed by physician office visit costs. Prior comorbidities and treatment type also significantly contributed to overall costs.Conclusion. Annual expenditures for AS patients in Turkey were comparable relative to European countries. Pharmaceutical expenditures cover a significant portion of the overall costs. Comparative effectiveness studies are necessary to further decrease health care costs of AS treatment.

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Moderating Effect of Vigorous Physical Activity on Health Care Costs among Adolescents: ABCD Growth Study

10.21203/rs.3.rs-691117/v1 ◽

2021 ◽

Author(s):

Lucas Gabriel Moraes Chagas ◽

Rômulo Araújo Fernandes ◽

Monique Yndawe Castanho Araujo ◽

Wésley Torres ◽

Jacqueline Bexiga Urban ◽

...

Keyword(s):

Physical Activity ◽

Health Care ◽

Health Care Costs ◽

Linear Models ◽

Health Care Cost ◽

Vigorous Physical Activity ◽

Present Sample ◽

Care Plans ◽

Objectively Measured ◽

Care Costs

Abstract Background: The relationship between physical activity and health care costs among adolescents is not yet clear in the literature.Objective: To analyze the relationship between physical activity and annual health care costs among adolescents.Methods: The present sample was composed of 85 adolescents of both sexes with ages ranging from 11 to 18 years (mean age 15.6±2.1). Health care costs were self-reported every month for 12 months, and information on health care values was verified at local pharmacies, private health care plans, and the National Health Service. The time spent in different physical activity intensities was objectively measured by accelerometers. Confounding variables were: sex, age, somatic maturation, body fatness, blood pressure, and components of dyslipidemia and insulin resistance. Multivariate models were generated using generalized linear models with gamma distribution and a log-link function.Results: The overall annual health care cost was US$ 733.60/ R$ 2,342.38 (medication: US$ 400.46 / R$ 1,278.66; primary and secondary care: US$ 333.14 / R$ 1,063.70). The time spent in vigorous physical activity (minutes/day) was negatively related to health care costs (r= -0.342 [95% CI: -0.537, - 0.139]; β= -0.06 cents (95% CI: -0.089, -0.031).Conclusion: Vigorous physical activity seems to be associated with lower health care costs among adolescents.

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Describing, explaining or predicting mental health care costs: a guide to regression models

The British Journal of Psychiatry ◽

10.1192/bjp.183.5.398 ◽

2003 ◽

Vol 183 (5) ◽

pp. 398-404 ◽

Cited By ~ 61

Author(s):

Graham Dunn ◽

Massimo Mirandola ◽

Francesco Amaddeo ◽

Michele Tansella

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Costs ◽

Regression Models ◽

Linear Models ◽

Least Square ◽

Small Samples ◽

Ordinary Least Square ◽

Mental Health Costs ◽

Care Costs

BackgroundAnalysis of the patterns of variation in health care costs and the determinants of these costs (including treatment differences) is an increasingly important aspect of research into the performance of mental health services.AimsTo encourage both investigators of the variation in health care costs and the consumers of their investigations to think more critically about the precise aims of these investigations and the choice of statistical methods appropriate to achieve them.MethodWe briefly describe examples of regression models that might be of use in the prediction of mental health costs and how one might choose which one to use for a particular research project.ConclusionsIf the investigators are primarily interested in explanatory mechanisms then they should seriously consider generalised linear models (but with careful attention being paid to the appropriate error distribution). Further insight is likely to be gained through the use of two-part models. For prediction we recommend regression on raw costs using ordinary least-square methods. Whatever method is used, investigators should consider how robust their methods might be to incorrect distributional assumptions (particularly in small samples) and they should not automatically assume that methods such as bootstrapping will allow them to ignore these problems.

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