Age and Gender Adjustment in Two Managed Care Organization:s The purpose of stan
ID: 3354057 • Letter: A
Question
Age and Gender Adjustment in Two Managed Care Organization:s The purpose of standardization is to make two or more populations "similar" along dimensions in which they differ. Earlier, we demonstrated two methods of age-adjustment. For example, we know that Florida has proportionately more older folks, and older folks die at higher rates than younger folks. In order to compare the mortality rate of Florida to Alaska, we needed to control for this disparity by adjusting for differences in the age mix of the two states. Conceptually, we can adjust for more than one dimension, e.g., age and gender, if we want to compare two or more populations, know that the age and gender mix will be different in those two populations, and also know that some disease-specific mortality rates depend on both age and gender. Such is the case with cardiovascular disease in two large MCOs, Bluegrass East (BGE) and Bluegrass West (BGW), the former with 100,000 members, and the latter with 120,000 members. Suppose we want to compare the cardiovascular mortality rate of BGE and BGW. Suppose that BGE has a higher proportion of older folks, and a higher proportion of women, than BGW. Assume that the crude disease-specific mortality rate for cardiovascular disease is 290 (per 100,000) in BGE and 160 (per 100,000) in BGW QUESTIONS 1. From these statistics alone, which MCO has the higher cardiovascular mortality rate? 2. is quite different. In BGW, 90% of the The member mix in BGE and BGV 55 years old compared to 77% in BGE. Refer to Table 6.7 to guide the calculation of age-adjusted cardiovascular mortality rates using the direct age- adjustment technique and the U.S. population as the standard. With age-adjusted rates, which MCO has the higher mortality rate? population is less than 3. Now assume that 60% of the members in BGW are men compared to 40% in BGE. Men have higher cardiovascular mortality rates than women. Refer to Table 6.8 to calculate age and gender adjusted cardiovascular mortality rates. With age- and gender-adjusted rates, which MCO has the higher cardiovascular mortality rate?Explanation / Answer
Q 1: From these statistics alone, BGE has the higher cardiovascular disease (CVD) mortality rate than BGW. Because BGE has the population of 100000 and the CVD rate of 290. Which means on per 100000 population their dies 290 people due to CVD disease. Whereas in BGW, there is 120000 population and the CVD death rate is of 160. By simple calculation, we can obtain that for every 100000 population their dies 133 people due to CVD in BGW, which is quite low as compared to BGE.
Q 2:
From the table above, we obtained that the standard ASDR of BGE (0.015) for age 1-54 is higher than BGW (0.0088) whereas standardized ASDR of BGW (15.77) for age 55+ is higher than BGE (8.07).
Q 3: Since we don't have any information regarding the age-specific sex distribution. Thus it is quite difficult to find the exact answer who has the higher standardized ASDR. Still, we have calculated the Standardization ASDR. Which is given in the table below:
From the table above, we obtained that the standard ASDR of BGE (0.092) for age 1-54 for male is higher than BGW (0.028) whereas standardized ASDR of BGW (53.57) for age 55+ for male is higher than BGE (45.23). For female, stand. ASDR for female is higher for BGW in both age-groups.