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Generalized Modeling Approaches to Risk Adjustment of Skewed Outcomes Data

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Author Info
Willard G. Manning
Anirban Basu
John Mullahy

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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., 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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Paper provided by National Bureau of Economic Research, Inc in its series NBER Technical Working Papers with number 0293.

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Date of creation: Oct 2003
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Handle: RePEc:nbr:nberte:0293

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I1 - Health, Education, and Welfare - - Health

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Anirban Basu & Willard G. Manning & John Mullahy, 2004. "Comparing alternative models: log vs Cox proportional hazard?," Health Economics, John Wiley & Sons, Ltd., vol. 13(8), pages 749-765. [Downloadable!]
  2. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June. [Downloadable!] (restricted)
  3. Mullahy, John, 1998. "Much ado about two: reconsidering retransformation and the two-part model in health econometrics," Journal of Health Economics, Elsevier, vol. 17(3), pages 247-281, June. [Downloadable!] (restricted)
  4. Blough, David K. & Madden, Carolyn W. & Hornbrook, Mark C., 1999. "Modeling risk using generalized linear models," Journal of Health Economics, Elsevier, vol. 18(2), pages 153-171, April. [Downloadable!] (restricted)
  5. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July. [Downloadable!] (restricted)
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  1. Frank Windmeijer, 2006. "GMM for panel count data models," Bristol Economics Discussion Papers 06/591, Department of Economics, University of Bristol, UK. [Downloadable!]
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  2. Onur Başer & Joseph C. Gardiner & Cathy J. Bradley & Hüseyin Yüce & Charles Given, 2006. "Longitudinal analysis of censored medical cost data," Health Economics, John Wiley & Sons, Ltd., vol. 15(5), pages 513-525. [Downloadable!]
  3. Deb, P & Trivedi, P. K & Zimmer, D. M, 2009. "Dynamic Cost-offsets of Prescription Drug Expenditures: Panel Data Analysis Using a Copula-based Hurdle Model," Health, Econometrics and Data Group (HEDG) Working Papers 09/15, HEDG, c/o Department of Economics, University of York. [Downloadable!]
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  4. Füssel, Hans-Martin, 2009. "New results on the influence of climate on the distribution of population and economic activity," MPRA Paper 13788, University Library of Munich, Germany. [Downloadable!]
  5. Jean-Paul Chaze, 2005. "Assessing household health expenditure with Box-Cox censoring models," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 893-907. [Downloadable!]
  6. Garming, Hildegard & Waibel, Hermann, 2006. "Willingness To Pay To Avoid Health Risks From Pesticides, A Case Study From Nicaragua," 46th Annual Conference, Giessen, Germany, October 4-6, 2006 14968, German Association of Agricultural Economists (GEWISOLA). [Downloadable!]
  7. Waibel, Hermann & Garming, Hildegard, 2007. "Pesticides And Farmer Health In Nicaragua: A Willingness To Pay Approach," Proceedings of the German Development Economics Conference, Göttingen 2007 7, Verein für Socialpolitik, Research Committee Development Economics. [Downloadable!]
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