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C29. Latent variable models of health care utilization and costs for use in pharmacoeconomic research
CLINICAL THERAPEUTICS”
C29. Latent Variable Models of Health Care Utilization and Costs for Use in Pharmacoeconomic Research R. Lennox Research Triangle Institute Longitudinal data sets of health insurance claims records have posed serious analytic challenges for health services researchers for many years. Nonnormality, spar&y, random and systematic measurement error, and autocorrelation have severely limited the usefulness of traditional analytic methods. Attempts to cope with these problems have led to the misapplication of statistical models (ie, traditional parametric models used with heavily skewed cost distributions) and/or the reliance on cumbersome solutions including nonlinear data transformations and distribution segmentation. However, there has been even less attention given to the measurement error problems of health insurance data. Diagnostic segments of health care costs are routinely summed into a composite of total health costs without regard to psychometric errors caused by the presence of comorbid illnesses, misdiagnosis, clerical errors, and even conscious attempts to conceal the actual medical problem to circumvent third-party payment regulations or to protect patients’ privacy. This report describes some of the recent advances in latent variable analysis used to control some of the more serious psychometric errors and demonstrates the comparative advantages of latent variable models over traditional techniques.
C30. Methodologic Issues in Pharmacoeconomic Evaluations of HMG-CoA Reductase Inhibitors Used in the lkeatment of Hyperlipidemia S.X. Kong, S.K. Gandhi, and S.Y. Crawford Department of Pharmacy AdministraGon, College of Pharmacy, University of Illinois at Chicago The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are effective in reducing blood cholesterol levels, a risk factor for coronary heart disease (U-ID). This study was designed to evaluate the published pharmacoeconomic studies on four HMG-CoA reductase inhibitors (fluvastatin, lovastatin, pravastatin, and simvastatin) used in the treatment of hyperlipidemia. A specially designed data collection form was used to extract data from 12 published pharmacoeconomic studies that involved at least one HMG-CoA reductase inhibitor. The results of this evaluation were provided in the form of summary tables listing pharmacoeconomic methods used, individual study results, dis0149-2918/96/$3.50
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C29. Latent Variable Models of Health Care Utilization and Costs for Use in Pharmacoeconomic Research R. Lennox Research Triangle Institute Longitudinal data sets of health insurance claims records have posed serious analytic challenges for health services researchers for many years. Nonnormality, spar&y, random and systematic measurement error, and autocorrelation have severely limited the usefulness of traditional analytic methods. Attempts to cope with these problems have led to the misapplication of statistical models (ie, traditional parametric models used with heavily skewed cost distributions) and/or the reliance on cumbersome solutions including nonlinear data transformations and distribution segmentation. However, there has been even less attention given to the measurement error problems of health insurance data. Diagnostic segments of health care costs are routinely summed into a composite of total health costs without regard to psychometric errors caused by the presence of comorbid illnesses, misdiagnosis, clerical errors, and even conscious attempts to conceal the actual medical problem to circumvent third-party payment regulations or to protect patients’ privacy. This report describes some of the recent advances in latent variable analysis used to control some of the more serious psychometric errors and demonstrates the comparative advantages of latent variable models over traditional techniques.
C30. Methodologic Issues in Pharmacoeconomic Evaluations of HMG-CoA Reductase Inhibitors Used in the lkeatment of Hyperlipidemia S.X. Kong, S.K. Gandhi, and S.Y. Crawford Department of Pharmacy AdministraGon, College of Pharmacy, University of Illinois at Chicago The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are effective in reducing blood cholesterol levels, a risk factor for coronary heart disease (U-ID). This study was designed to evaluate the published pharmacoeconomic studies on four HMG-CoA reductase inhibitors (fluvastatin, lovastatin, pravastatin, and simvastatin) used in the treatment of hyperlipidemia. A specially designed data collection form was used to extract data from 12 published pharmacoeconomic studies that involved at least one HMG-CoA reductase inhibitor. The results of this evaluation were provided in the form of summary tables listing pharmacoeconomic methods used, individual study results, dis0149-2918/96/$3.50
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