Cited by 760Statistical Distribution Estimation and ApplicationsStatistical Methods and Bayesian InferenceHealthcare Policy and Management

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Generalized modeling approaches to risk adjustment of skewed outcomes data

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Manning, Willard G., Basu, Anirban, Mullahy, John·2005·Journal of Health Economics

DOI 10.1016/j.jhealeco.2004.09.011

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Abstract

There are two broad classes of models used to address the econometric problems caused by skewness in data commonly encountered in health care applications: (1) transformation to deal with skewness (e.g., ordinary least square (OLS) on ln(y)); and (2) alternative weighting approaches based on exponential conditional models (ECM) and generalized linear model (GLM) approaches. In this paper, we encompass these two classes of models using the three parameter generalized Gamma (GGM) distribution, which includes several of the standard alternatives as special cases-OLS with a normal error, OLS for the log-normal, the standard Gamma and exponential with a log link, and the Weibull. Using simulation methods, we find the tests of identifying distributions to be robust. The GGM also provides a potentially more robust alternative estimator to the standard alternatives. An example using inpatient expenditures is also analyzed.

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Authors: Manning, W. G., Basu, A., & Mullahy, J.
Affiliations: University of Chicago (US)
National Bureau of Economic Research (US)
Corresponding author: Manning, Willard G.
ORCID: Basu, Anirban
Mullahy, John
Venue: Journal of Health Economics
Publisher: Elsevier BV
Published: 2005-05
Volume: 24
Issue: 3
Pages: 465-488
ISSN: 0167-6296 (ISSN-L)
DOI: 10.1016/j.jhealeco.2004.09.011
OpenAlex: W3122533613
Cited by: 760
References: 17
Citations by year: 2026: 21 · 2025: 27 · 2024: 29 · 2023: 32 · 2022: 38 · 2021: 40 · 2020: 43 · 2019: 52 · 2018: 51 · 2017: 52 · 2016: 41 · 2015: 57 · 2014: 46 · 2013: 56 · 2012: 42
FWCI: 17.64
Type: journal article
Language: en
Open access: green
www.nber.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Health Economics (publishedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Funders: National Institutes of Health (5r01aa012664-03)
National Institute on Alcohol Abuse and Alcoholism (1 R01 AA 12664-01 A2)
Topics: Physical Sciences › Mathematics › Statistics and Probability › Statistical Distribution Estimation and Applications
Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods and Bayesian Inference
Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords: risk adjustment, logarithmic transformation, generalized linear models, hospital costs
MeSH terms: United States, Models, Statistical, Risk Adjustment

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Generalized modeling approaches to risk adjustment of skewed outcomes data

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