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A multilevel modelling approach to analysis of patient costs under managed care 1
Author(s) -
Carey Kathleen
Publication year - 2000
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/1099-1050(200007)9:5<435::aid-hec523>3.0.co;2-z
Subject(s) - managed care , ordinary least squares , health care , sample (material) , multilevel model , medical care , medicine , health care delivery , business , family medicine , econometrics , computer science , economics , economic growth , chemistry , chromatography , machine learning
The growth of the managed care model of health care delivery in the USA has led to broadened interest in the performance of health care providers. This paper uses multilevel modelling to analyse the effects of managed care penetration on patient level costs for a sample of 24 medical centres operated by the Veterans Health Administration (VHA). The appropriateness of a two level approach to this problem over ordinary least squares (OLS) is demonstrated. Results indicate a modicum of difference in institutions' performance after controlling for patient effects. Facilities more heavily penetrated by the managed care model may be more effective at controlling costs of their sicker patients. Copyright © 2000 John Wiley & Sons, Ltd.