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Table 5 Prevalence of selected diseases among predicted top user groups by five risk adjustment models at three outcome thresholds

From: Comparison of alternative risk adjustment measures for predictive modeling: high risk patient case finding using Taiwan's National Health Insurance claims

  Actual Top Users Model 1:
Demographics
Model 2:
ACGs & Demographics
Model 3:
ADGs, 19 EDCs & Demographics
Model 4:
2002 Expenditures & Demographics
Model 5:
ADGs, 19 EDCs, 2002 Expenditures & Demographics
2003 Top 0.5% predicted user
# of Conditions 0.963 0.988 1.329 1.238 1.160 1.251
Asthma 7.85% 9.27% 12.76% 8.37% 10.25% 8.79%
Hypertension 42.98% 45.56% 55.14% 57.32% 50.82% 54.81%
Depression 6.20% 1.93% 5.35% 3.35% 7.79% 7.95%
Diabetes 21.07% 19.31% 27.57% 33.89% 27.46% 33.05%
COPD 18.18% 22.78% 32.10% 20.92% 19.67% 20.50%
2003 Top 1% predicted user
# of Conditions 0.967 0.971 1.351 1.256 1.270 1.271
Asthma 9.55% 7.61% 14.02% 10.26% 11.99% 11.81%
Hypertension 41.67% 46.91% 55.46% 54.33% 53.05% 52.95%
Depression 6.50% 2.67% 7.63% 7.85% 6.71% 8.76%
Diabetes 20.93% 20.16% 27.84% 30.38% 29.27% 31.57%
COPD 18.09% 19.75% 30.10% 22.74% 26.02% 22.00%
2003 Top 5% predicted user
# of Conditions 1.030 0.981 1.283 1.459 1.288 1.425
Asthma 9.00% 7.50% 11.84% 12.52% 10.39% 12.17%
Hypertension 44.83% 48.38% 57.99% 66.33% 59.73% 64.45%
Depression 6.24% 2.40% 6.13% 8.40% 6.00% 8.30%
Diabetes 26.27% 21.14% 26.78% 34.53% 29.88% 34.32%
COPD 16.62% 18.70% 25.54% 24.13% 22.85% 23.22%