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A collection of marginalized two-part random-effects models for analyzing medical expenditure panel data: Impact of the New Cooperative Medical Scheme on healthcare expenditures in China.

Author
Abstract
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Marginalized two-part random-effects generalized Gamma models have been proposed for analyzing medical expenditure panel data with excessive zeros. While these models provide marginal inference on expected healthcare expenditures, the usual unilateral specification of heteroscedastic variance on one of the two shape parameters for the generalized Gamma distribution in these models fails to encompass important special cases within the generalized gamma modeling framework. In this article, we construct marginalized two-part random-effects models that employ the log-normal, log-skew-normal, generalized Gamma, Weibull, Gamma, and inverse Gamma distributions to delineate the spectrum of nonzero healthcare expenditures in the second part of the models. These marginalized models supply additional choices for analyzing healthcare expenditure panel data with excessive zeros. We review the concepts of marginal effect and incremental effect, and summarize how these effects are estimated. For studies whose primary goal is to make inference on marginal effect or incremental effect of an independent variable with respect to healthcare expenditures, we advocate empirical mean square error criterion and information criteria to choose among candidate models. Then, we use the proposed models in an empirical analysis to examine the impact of the New Cooperative Medical Scheme on healthcare expenditures among older adults in rural China.

Year of Publication
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2018
Journal
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Statistical methods in medical research
Number of Pages
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962280218784725
Date Published
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2018
ISSN Number
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0962-2802
URL
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http://journals.sagepub.com/doi/abs/10.1177/0962280218784725?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
DOI
:
10.1177/0962280218784725
Short Title
:
Stat Methods Med Res
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