Journal of Health Economics · 2024 · Apostolos Davillas、Andrew M. Jones
中文摘要
本文考察表观遗传学生物学年龄在预测后续医疗利用中的作用。我们使用英国Understanding Society（理解社会）面板的纵向数据，利用了基线表观遗传学生物学年龄测度以及基线后5-12年收集的全科医生（GP）就诊、门诊（OP）就诊和医院住院（IP）治疗数据的可得性。通过最小绝对收缩与选择算子（LASSO）回归分析，并控制参与者的既往健康状况、基线时的生物学潜在健康状况及社会经济预测变量，我们发现生物学年龄被选为未来GP就诊和IP治疗的预测变量，而对未来OP就诊被选出的是实际年龄而非生物学年龄。变量选择后的预测分析与Shapley-Shorrocks分解——将我们偏好的预测模型与以实际年龄替代生物学年龄的模型进行比较——表明，生物学老化在预测未来IP治疗的模型中作用更强，而在承担"守门"功能的GP就诊预测模型中作用较弱。
Abstract
We explore the role of epigenetic biological age in predicting subsequent health care utilisation. We use longitudinal data from the UK Understanding Society panel, capitalising on the availability of baseline epigenetic biological age measures along with data on general practitioner (GP) consultations, outpatient (OP) visits, and hospital inpatient (IP) care collected 5-12 years from baseline. Using least absolute shrinkage and selection operator (LASSO) regression analyses and accounting for participants' pre-existing health conditions, baseline biological underlying health, and socio-economic predictors we find that biological age is selected as a predictor of future GP consultations and IP care, while chronological rather than biological age is selected for future OP visits. Post-selection prediction analysis and Shapley-Shorrocks decompositions, comparing our preferred prediction models to models that replace biological age with chronological age, suggest that biological ageing has a stronger role in the models predicting future IP care as opposed to "gatekeeping" GP consultations.