Regression Toward the Mean in Medical Care Costs
Implications for Biased Selection in Health Maintenance Organizations
Bibliographic Data
| ID | 9101563 |
|---|---|
| Authors | W Pete Welch (Office of Management, corresponding author) |
| Year | 1985 |
| Volume | 23 |
| Issue | 11 |
| Pages | 1234-1241 |
| Publication date | 1985-11-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-198511000-00002 |
| PMID | 3934471 |
| OpenAlex | W2111230518 |
| Language | EN |
| Citations received | 4 |
| References cited | 3 |
As more Americans choose among insurance plans, the possibility of biased selection increases in importance. Although regression toward the mean is recognized as a common problem in evaluating social programs, it has generally been ignored in studies of biased selection. Suppose that people are included in a group simply because they had expenditures in one year $100 below the mean; that is, health status or other risk factors are not part of the selection criteria. Empirically, the expected difference in the following year is about $20 and appears to fall in each subsequent year. This pattern holds for the elderly and nonelderly. Evidence of lower pre-enrollment expenditure of prepaid group practice (PGP) enrollees can be interpreted in several ways. Under one interpretation, PGP enrollees are assumed to be a random sample conditional on pre-enrollment expenditure, such that biased selection is one fifth of estimates based on 1 year of data and one half of estimates based on 4 years of data. This article cannot resolve the issue of alternative interpretations; it only raises it
Actuarial science · Econometrics · Economics · Health care · Health insurance · Interpretation (philosophy) · Medical Expenditure Panel Survey · Regression · Regression analysis · Regression toward the mean · Sample (material) · Selection (genetic algorithm) · Selection bias · Sociology · Statistics · Computer Science · Demography · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Mathematics · Medicine · Primary Care and Health Outcomes · Psychology
| Unique citing works | 4 |
|---|---|
| Citations per year | 0,11 |
| Citation span | 1991 - 2009 (19) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 3 |