Modelling Correlated Healthcare Costs with Many Zeros: A Two-Part Random Effects Approach

Healthcare costs typically exhibit a substantial proportion of zero values together with very large positive values. For example, healthy people have no costs recorded in a given year whereas certain individuals may incur large medical expenses that increase tremendously by disease severity. Moreove...

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Bibliographic Details
Main Authors: Lee, Andy, Hui, Y., Yau, K.
Other Authors: Wenchang Fang
Format: Conference Paper
Published: Academy of Taiwan Information Systems Research 2012
Online Access:http://hdl.handle.net/20.500.11937/27510
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author Lee, Andy
Hui, Y.
Yau, K.
author2 Wenchang Fang
author_facet Wenchang Fang
Lee, Andy
Hui, Y.
Yau, K.
author_sort Lee, Andy
building Curtin Institutional Repository
collection Online Access
description Healthcare costs typically exhibit a substantial proportion of zero values together with very large positive values. For example, healthy people have no costs recorded in a given year whereas certain individuals may incur large medical expenses that increase tremendously by disease severity. Moreover, such semi-continuous data are often collected in hierarchical form and therefore correlated. A flexible two-part modelling approach is proposed to analyze the heterogeneous and correlated cost data. In the binary part, the odds of cost being positive are modelled using a logistic mixed regression model. In the continuous part, the mean cost given that costs have actually been incurred is assessed by a gamma mixed regression model. Random effects are incorporated within the two parts to account for correlation of the observations. Model fitting and inference are performed through the Gaussian quadrature technique, which can be implemented conveniently in statistical packages. The method is applied to evaluate the effectiveness of an occupational safety intervention program using longitudinal compensation claims cost data. The findings have important implications on healthcare administration and financial planning.
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institution Curtin University Malaysia
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last_indexed 2025-11-14T08:06:10Z
publishDate 2012
publisher Academy of Taiwan Information Systems Research
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spelling curtin-20.500.11937-275102023-02-07T08:01:18Z Modelling Correlated Healthcare Costs with Many Zeros: A Two-Part Random Effects Approach Lee, Andy Hui, Y. Yau, K. Wenchang Fang Healthcare costs typically exhibit a substantial proportion of zero values together with very large positive values. For example, healthy people have no costs recorded in a given year whereas certain individuals may incur large medical expenses that increase tremendously by disease severity. Moreover, such semi-continuous data are often collected in hierarchical form and therefore correlated. A flexible two-part modelling approach is proposed to analyze the heterogeneous and correlated cost data. In the binary part, the odds of cost being positive are modelled using a logistic mixed regression model. In the continuous part, the mean cost given that costs have actually been incurred is assessed by a gamma mixed regression model. Random effects are incorporated within the two parts to account for correlation of the observations. Model fitting and inference are performed through the Gaussian quadrature technique, which can be implemented conveniently in statistical packages. The method is applied to evaluate the effectiveness of an occupational safety intervention program using longitudinal compensation claims cost data. The findings have important implications on healthcare administration and financial planning. 2012 Conference Paper http://hdl.handle.net/20.500.11937/27510 Academy of Taiwan Information Systems Research restricted
spellingShingle Lee, Andy
Hui, Y.
Yau, K.
Modelling Correlated Healthcare Costs with Many Zeros: A Two-Part Random Effects Approach
title Modelling Correlated Healthcare Costs with Many Zeros: A Two-Part Random Effects Approach
title_full Modelling Correlated Healthcare Costs with Many Zeros: A Two-Part Random Effects Approach
title_fullStr Modelling Correlated Healthcare Costs with Many Zeros: A Two-Part Random Effects Approach
title_full_unstemmed Modelling Correlated Healthcare Costs with Many Zeros: A Two-Part Random Effects Approach
title_short Modelling Correlated Healthcare Costs with Many Zeros: A Two-Part Random Effects Approach
title_sort modelling correlated healthcare costs with many zeros: a two-part random effects approach
url http://hdl.handle.net/20.500.11937/27510