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首页> 外文期刊>Journal of applied statistics >Confidence Limits for Estimates of Totals from Stratified Samples, with Application to Medicare Part B Overpayment Audits
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Confidence Limits for Estimates of Totals from Stratified Samples, with Application to Medicare Part B Overpayment Audits

机译：从分层样本中得出的总数估计值的置信限度，适用于Medicare B部分超额支付审计

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摘要

Superpopulation models are proposed that should be appropriate for modelling sample-based audits of Medicare payments and other overpayment situations. Simulations are used to estimate the coverage probabilities of confidence intervals formed using the standard Stratified Expansion and Combined Ratio estimators of the total. Despite severe departures from the usual model of normal deviations, these methods have actual coverage probabilities reasonably close to the nominal level specified by the US government's sampling guidelines. An exception occurs when all claims from a single sampling unit are either completely allowed, or completely denied, and for this situation an alternative is explored. A balanced sampling design is also examined, but shown to make no improvement over ordinary stratified samples used in conjunction with ratio estimates.
机译：提出了超级人口模型，该模型应适合于建模基于样本的医疗保险付款和其他超额付款情况的审计。使用模拟来估计使用总数的标准分层扩展和组合比率估计量形成的置信区间的覆盖概率。尽管与通常的正态偏差模型有很大的出入，但这些方法的实际覆盖率相当接近美国政府抽样指南规定的名义水平。当完全允许或完全拒绝来自单个采样单元的所有索赔时，就会发生例外，并且在这种情况下，将寻求替代方法。还检查了平衡采样设计，但显示与比例估计结合使用的普通分层样本没有任何改善。

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