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Objectives

This article has two main purposes. Firstly, to model the integrated healthcare expenditure for the entire population of a health district in Spain, according to multimorbidity, using Clinical Risk Groups (CRG). Secondly, to show how the predictive model is applied to the allocation of health budgets.

Methods

The database used contains the information of 156,811 inhabitants in a Valencian Community health district in 2013. The variables were: age, sex, CRG’s main health statuses, severity level, and healthcare expenditure. The two-part models were used for predicting healthcare expenditure. From the coefficients of the selected model, the relative weights of each group were calculated to set a case-mix in each health district.

Results

Models based on multimorbidity-related variables better explained integrated healthcare expenditure. In the first part of the two-part models, a logit model was used, while the positive costs were modelled with a log-linear OLS regression. An adjusted R2 of 46–49% between actual and predicted values was obtained. With the weights obtained by CRG, the differences found with the case-mix of each health district proved most useful for budgetary purposes.

Conclusions

The expenditure models allowed improved budget allocations between health districts by taking into account morbidity, as opposed to budgeting based solely on population size.  相似文献   
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在甘肃引黄灌区的灌耕灰钙土区域,通过玉米/鹰嘴豆间作种植,采用蒋柏藩、顾益初石灰性土壤无机磷分级方法研究了施磷水平和间作种植方式对玉米、鹰嘴豆土壤无机磷素形态的影响。结果表明:研究区各无机磷形态含量顺序为O-P>Ca10-P>Ca8-P>Al-P>Fe-P>Ca2-P,施磷能够显著提高玉米和鹰嘴豆土壤中Ca2-P、Ca8-P、Al-P和Fe-P的含量,O-P和Ca10-P的含量不随施磷量增加发生显著性变化;与单作相比,间作种植对鹰嘴豆土壤带各无机磷组分含量没有显著影响,但间作玉米种植带土壤各组分无机磷含量均低于单作土壤,其中不施磷肥处理下Fe-P、施纯磷 40 kg·hm-2处理下Al-P及施纯磷 80 kg·hm-2处理下Ca10-P的含量显著低于单作土壤。  相似文献   
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Background

Tuberculosis (TB) is an infectious bacterial disease; remains as one of the important public health problem affecting every part of the world. Substantial number of TB cases are reported from Sri Lanka every year irrespective of its strong preventive health system. The aim of this analysis is to describe the characteristics of TB patients and to assess the factors associated with sputum conversion. This analysis was based on the data from the District Chest Clinic of Kalutara district, Sri Lanka.

Methods

Information of all newly diagnosed and registered patients in the District Chest Clinic, Kalutara in year 2013 were ascertained. Out of 687 newly reported TB patients, 669 records were included in final analysis.

Results

Majority of patients were males (n = 451, 67.4%), in the age group of 36–60 years (n = 306, 45.7%) and underweight (n = 359, 61.7%). Substantial proportion of normal weight or overweight adult patients (92.1%) had sputum conversion at 2–3 months as compared to underweight adult patients (82.5%) (p = 0.034). Those who smoke tobacco is less likely to have sputum conversion at 2–3 months as compared to non-smokers (90.2% vs. 82.1%, p = 0.045).

Conclusion

Provision of good nutrition, maintaining of appropriate body mass index (i.e., BMI), and abstinence from smoking and alcohol consumption are important for sputum conversion among smear-positive pulmonary TB patients.  相似文献   
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