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Detection of Health Insurance Fraud with Discrete Choice Model: Evidence from Medical Expense Insurance in China 用离散选择模型检测医疗保险欺诈:来自中国医疗费用保险的证据
Pub Date : 2014-06-15 DOI: 10.2139/ssrn.2459343
Yi Yao, Qixiang Sun, Shan-Hui Lin
Health insurance fraud increases the inefficiency and inequality in our society. To address the widespread problem, cost effect techniques are in need to detect fraudulent claims. With a dataset from medical expense insurance in China, we propose a discrete choice model to identify predicting factors of fraudulent claims, and we address the major limitations of discrete choice model by considering over sampling of fraudulent cases, as well as mislabeling of legitimate claims (omission error). Our results show that a few factors, such as hospital’s qualification and policyholder’s renewal status, could be used to predict fraudulent claims for further investigation.
医疗保险欺诈增加了我们社会的低效率和不平等。为了解决这个普遍存在的问题,需要成本效益技术来检测欺诈性索赔。利用中国医疗费用保险数据集,我们提出了一个离散选择模型来识别欺诈性索赔的预测因素,并通过考虑欺诈性案例的过度抽样以及合法索赔的错误标记(遗漏错误)来解决离散选择模型的主要局限性。我们的研究结果表明,一些因素,如医院的资质和投保人的续保状态,可以用来预测欺诈性索赔,以便进一步调查。
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引用次数: 1
A Bayesian Semiparametric Approach for Endogeneity and Heterogeneity in Choice Models 选择模型内生性和异质性的贝叶斯半参数方法
Pub Date : 2014-05-01 DOI: 10.2139/ssrn.2270993
Yang Li, Asim Ansari
Marketing variables that are included in consumer discrete choice models are often endogenous. Extant treatments using likelihood-based estimators impose parametric distributional assumptions, such as normality, on the source of endogeneity. These assumptions are restrictive because misspecified distributions have an impact on parameter estimates and associated elasticities. The normality assumption for endogeneity can be inconsistent with some marginal cost specifications given a price-setting process, although they are consistent with other specifications. In this paper, we propose a heterogeneous Bayesian semiparametric approach for modeling choice endogeneity that offers a flexible and robust alternative to parametric methods. Specifically, we construct centered Dirichlet process mixtures CDPM to allow uncertainty over the distribution of endogeneity errors. In a similar vein, we also model consumer preference heterogeneity nonparametrically via a CDPM. Results on simulated data show that incorrect distributional assumptions can lead to poor recovery of model parameters and price elasticities, whereas the proposed semiparametric model is able to robustly recover the true parameters in an efficient fashion. In addition, the CDPM offers the benefits of automatically inferring the number of mixture components that are appropriate for a given data set and is able to reconstruct the shape of the underlying distributions for endogeneity and heterogeneity errors. We apply our approach to two scanner panel data sets. Model comparison statistics indicate the superiority of the semiparametric specification and the results show that parameter and elasticity estimates are sensitive to the choice of distributional forms. Moreover, the CDPM specification yields evidence of multimodality, skewness, and outlying observations in these real data sets. Data, as supplemental material, are available at http://dx.doi.org/10.1287/mnsc.2013.1811 . This paper was accepted by J. Miguel Villas-Boas, marketing.
包含在消费者离散选择模型中的营销变量通常是内生的。现有的基于似然估计的处理方法对内生性的来源施加了参数分布假设,如正态性。这些假设是限制性的,因为错误指定的分布对参数估计和相关的弹性有影响。内生性的正态性假设可能与给定定价过程的某些边际成本规格不一致,尽管它们与其他规格一致。在本文中,我们提出了一种异构贝叶斯半参数方法来建模选择内生性,它提供了一种灵活和鲁棒的替代参数方法。具体来说,我们构建了中心狄利克雷过程混合CDPM,以允许内质性误差分布的不确定性。同样,我们也通过CDPM对消费者偏好异质性进行非参数化建模。模拟数据的结果表明,不正确的分布假设会导致模型参数和价格弹性的较差恢复,而所提出的半参数模型能够有效地鲁棒恢复真实参数。此外,CDPM还提供了自动推断适合给定数据集的混合成分数量的好处,并且能够重建内质性和异质性误差的潜在分布形状。我们将我们的方法应用于两个扫描面板数据集。模型比较统计表明了半参数规范的优越性,结果表明参数估计和弹性估计对分布形式的选择很敏感。此外,CDPM规范在这些真实数据集中产生了多模态、偏态和离群观测的证据。作为补充资料的数据可在http://dx.doi.org/10.1287/mnsc.2013.1811上获得。这篇论文被市场营销学的J. Miguel Villas-Boas接受。
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引用次数: 41
What Clients Want: Choices between Lawyers' Offerings 客户想要什么:律师服务之间的选择
Pub Date : 2014-02-10 DOI: 10.2139/ssrn.2591304
F. Felsö, S. Onderstal, J. Seldeslachts
We analyze a client's choice of contract in auctions where Dutch law firms compete for routine cases. The distinguishing feature here is that lawyers may submit bids with any fee arrangement they prefer: an hourly rate, a fixed fee or a mixed fee, which is a time-capped fixed fee plus an hourly rate for any additional hours should the case take longer than expected. Furthermore, this format of selling legal services is unusual in that it both forces lawyers to compete directly against each other and allows clients to easily compare these different offers. We empirically estimate a choice model for clients and find robust evidence that hourly rate bids are a client's least-preferred choice. Our findings tentatively contradict lawyers' often made argument that hourly rates are in a client's best interest.
我们分析了一位客户在荷兰律师事务所竞争常规案件的拍卖中对合同的选择。这里的显著特点是,律师可以按照他们喜欢的任何收费安排提交投标:按小时收费、固定收费或混合收费。混合收费是有时间限制的固定收费,加上如果案件花费的时间超过预期,则按小时收费。此外,这种销售法律服务的形式是不寻常的,因为它既迫使律师直接相互竞争,又允许客户轻松地比较这些不同的报价。我们根据经验估计了客户的选择模型,并发现了强有力的证据,证明小时费率投标是客户最不喜欢的选择。我们的发现暂时反驳了律师们经常提出的每小时收费符合客户最佳利益的论点。
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引用次数: 1
Compensated Discrete Choice with Particular Reference to Labor Supply 特别考虑劳动力供给的补偿离散选择
Pub Date : 2014-01-31 DOI: 10.2139/ssrn.2393896
J. Dagsvik, S. Strøm, Marilena Locatelli
Dagsvik and Karlstrom (2005) have demonstrated how one can compute Compensating Variation and Compensated Choice Probabilities by means of analytic formulas in the context of discrete choice models. In this paper we offer a new and simplified derivation of the compensated probabilities. Subsequently, we discuss the application of this methodology to compute compensated labor supply responses (elasticities) in a particular discrete choice labor supply model. Whereas the Slutsky equation holds in the case of the standard microeconomic model with deterministic preferences, this is not so in the case of random utility models. When the non-labor income elasticity is negative the Slutsky equation implies that the compensated wage elasticity is higher than the uncompensated one. In contrast, in our random utility model we show empirically that in a majority of cases the uncompensated wage elasticity is in fact the highest one. We also show that when only the deterministic part of the utility function is employed to yield optimal hours and related elasticities, these elasticities are numerically much higher and decline more sharply across deciles than the random utility ones.
Dagsvik和Karlstrom(2005)展示了如何在离散选择模型的背景下通过解析公式计算补偿变化和补偿选择概率。本文给出了补偿概率的一种新的简化推导。随后,我们讨论了该方法在特定的离散选择劳动供给模型中计算有偿劳动供给响应(弹性)的应用。尽管斯卢茨基方程适用于具有确定性偏好的标准微观经济模型,但在随机实用新型的情况下却并非如此。当非劳动收入弹性为负时,斯卢茨基方程表明有补偿的工资弹性高于无补偿的工资弹性。相反,在我们的随机实用模型中,我们的经验表明,在大多数情况下,未补偿的工资弹性实际上是最高的。我们还表明,当仅使用效用函数的确定性部分来产生最佳工时和相关弹性时,这些弹性在数值上要高得多,并且在十分位数上比随机效用函数下降得更快。
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引用次数: 0
The Perceived Unreliability of Rank-Ordered Data: An Econometric Origin and Implications 秩序数据的感知不可靠性:计量经济学的起源和影响
Pub Date : 2012-11-04 DOI: 10.2139/ssrn.2172145
H. I. Yoo
The problem of unstable coecients in the rank-ordered logit model has been traditionally interpreted as a sign that survey respondents fail to provide reliable ranking responses. This paper shows that the problem may embody the inherent sensitivity of the model to stochastic misspecification instead. Even a minor departure from the postulated random utility function can induce the problem, for instance when rank-ordered logit is estimated whereas the true additive disturbance is iid normal over alternatives. Related implications for substantive analyses and further modelling are explored. In general, a well-speci ed random coecient rank-ordered logit model can mitigate, though not eliminate, the problem and produce analytically useful results. The model can also be generalised to be more suitable for forecasting purposes, by accommodating that stochastic misspecification matters less for individuals with more deterministic preferences. An empirical analysis using an Australian nursing job preferences survey shows that the estimates behave in accordance with these implications.
秩序logit模型中不稳定系数的问题传统上被解释为调查对象不能提供可靠的排序回答的标志。本文表明,该问题可能体现了模型对随机错规范的固有敏感性。即使是对假设的随机效用函数的微小偏离也会引起问题,例如,当估计秩有序logit时,而真正的加性干扰在替代方案上是非正态的。对实质性分析和进一步建模的相关影响进行了探讨。一般来说,一个规范良好的随机系数秩序logit模型可以减轻(尽管不能消除)这个问题,并产生解析上有用的结果。该模型也可以被推广为更适合于预测目的,通过适应随机错误规范对具有更多确定性偏好的个体的影响较小。一项使用澳大利亚护理工作偏好调查的实证分析表明,估计行为符合这些含义。
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引用次数: 3
A Copula-Based Direct Utility Approach with Various Correlations 基于copula的多种关联直接效用方法
Pub Date : 2012-11-01 DOI: 10.2139/ssrn.2174789
D. Jun, Chul Kim
A direct utility approach can handle multiple discrete/continuous choice outcomes. However, there is a trade-off between allowing correlations between unobserved perceived qualities of two alternatives and computational burden. If we allow the correlations, then we have to do numerical integrations for getting likelihoods, whereas if we give up the correlations, then we can get closed form likelihood. Thus, we suggest a new copula-based direct utility approach that not only allows the correlations but also provides closed form of likelihood. Empirically, we find the existence of the correlations between unobserved qualities of two alternatives. Ignoring the correlations may cause the misunderstanding of the joint-purchases.
直接效用方法可以处理多个离散/连续选择结果。然而,在允许两种选择的未观察到的感知质量之间的相关性和计算负担之间存在权衡。如果我们允许相关性,那么我们就必须做数值积分来得到可能性,而如果我们放弃相关性,那么我们就可以得到封闭形式的可能性。因此,我们提出了一种新的基于copula的直接效用方法,它不仅允许相关性,而且提供了似然的封闭形式。从经验上,我们发现两种选择的未观察到的品质之间存在相关性。忽略这种相关性可能会导致对共同购买的误解。
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引用次数: 0
A Tractable Estimator for General Mixed Multinomial Logit Models 一般混合多项Logit模型的可处理估计
Pub Date : 2012-09-01 DOI: 10.26509/WP-201219
J. James
The mixed logit is a framework for incorporating unobserved heterogeneity in discrete choice models in a general way. These models are difficult to estimate because they result in a complicated incomplete data likelihood. This paper proposes a new approach for estimating mixed logit models. The estimator is easily implemented as iteratively re-weighted least squares: the well known solution for complete data likelihood logits. The main benefit of this approach is that it requires drastically fewer evaluations of the simulated likelihood function, making it significantly faster than conventional methods that rely on numerically approximating the gradient. The method is rooted in a generalized expectation and maximization (GEM) algorithm, so it is asymptotically consistent, efficient, and globally convergent.
混合逻辑是一种将离散选择模型中未观察到的异质性以一般方式纳入的框架。这些模型难以估计,因为它们导致复杂的不完全数据似然。本文提出了一种估计混合logit模型的新方法。估计器很容易实现为迭代重加权最小二乘:众所周知的完全数据似然对数的解决方案。这种方法的主要优点是,它需要大大减少模拟似然函数的评估,使其比依赖于数值近似梯度的传统方法要快得多。该方法基于广义期望与最大化(GEM)算法,具有渐近一致性、高效性和全局收敛性。
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引用次数: 2
Accounting Information Releases and CDS Spreads 会计信息发布和CDS价差
Pub Date : 2012-01-19 DOI: 10.2139/ssrn.1874127
Redouane Elkamhi, Kris Jacobs, Hugues Langlois, Chayawat Ornthanalai
We show that accounting information releases generate large and immediate price impacts, i.e. jumps, in credit default swap (CDS) spreads. Our approach is multivariate, which allows for identification of information events under the presence of confounding news, such as credit events and other simultaneous news arrivals. The economic impact of accounting news releases is twice as large as the impact of credit-related news. Good and bad news impact jumps in CDS spreads asymmetrically, and unscheduled announcements are more likely to cause jumps than scheduled ones. The arrival of accounting information is quickly absorbed in CDS spreads, suggesting efficient price discovery in the CDS market.
我们表明,会计信息的发布会产生巨大而直接的价格影响,即信用违约掉期(CDS)价差的跃升。我们的方法是多元的,它允许在混杂新闻存在的情况下识别信息事件,如信贷事件和其他同时到来的新闻。会计新闻发布对经济的影响是信贷相关新闻的两倍。好消息和坏消息对CDS价差的影响是不对称的,而计划外的公告比计划内的公告更有可能引起跳升。会计信息的到来很快被CDS价差吸收,表明CDS市场的价格发现是有效的。
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引用次数: 18
Improving the Art, Craft and Science of Economic Credit Risk Scorecards Using Random Forests: Why Credit Scorers and Economists Should Use Random Forests 使用随机森林改进经济信用风险记分卡的艺术、工艺和科学:为什么信用评分者和经济学家应该使用随机森林
Pub Date : 2011-06-09 DOI: 10.2139/ssrn.1861535
Dhruv Sharma
This paper outlines an approach to improving credit score modeling using random forests and compares random forests with logistic regression. It is shown that on data sets where variables have multicollinearity and complex interrelationships random forests provide a more scientific approach to analyzing variable importance and achieving optimal predictive accuracy. In addition it is shown that random forests should be used in econometric and credit risk models as they provide a powerful too to assess meaning of variables not available in standard regression models and thus allow for more robust findings.
本文概述了一种利用随机森林改进信用评分建模的方法,并将随机森林与逻辑回归进行了比较。研究表明,在变量具有多重共线性和复杂相互关系的数据集上,随机森林提供了一种更科学的方法来分析变量的重要性并获得最佳的预测精度。此外,研究表明,随机森林应该用于计量经济和信用风险模型,因为它们提供了一个强大的工具来评估标准回归模型中不可用的变量的含义,从而允许更稳健的发现。
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引用次数: 13
Some Experiments Comparing Logistic Regression and Random Forests Using Synthetic Data and the Interaction Miner Algorithm 使用合成数据和交互挖掘算法比较逻辑回归和随机森林的一些实验
Pub Date : 2011-06-05 DOI: 10.2139/ssrn.1858424
Dhruv Sharma
This paper uses synthetic datasets to classify the conditions in which random forest may outperform more traditional techniques such as logistic regression. We explore the theoretical implications of these experimental findings, and work towards building a theory based approach to data mining. During the course of these experiments we take the simulations where random forests dominate and add additional dimensionality to the data and run logistic regression using the additional attributes through the I* interaction miner algorithm outlined in Sharma 2011. Using the I* procedure with adequate amount of interaction terms the logistic regression can be made to match performance of random forests in the synthetic data sets where random forests dominate (Sharma, 2011). This makes it seem the interaction miner algorithm along with some minimal sufficient amount of interaction and transformations allow logistic regression to match ensemble performance. This implies that, without a certain amount of dimensionality in the data interaction, miner and logistic regression do not benefit from the interactions. Breiman and other work shows Random Forests thrive on dimensionality that said from experiences with various data sets adding additional artificial dimensionality doesn’t help forest (Breiman, 2001). There appears to be some minimum or necessary and sufficient amount of dimensionality after which more information cannot be extracted from the data. The good news is dimensionality can be created using the icreater function which add Tukey’s re-expressions automatically to the data (log, negative reciprocal, and sqrt).
本文使用合成数据集对随机森林可能优于逻辑回归等更传统技术的条件进行分类。我们探索这些实验结果的理论含义,并致力于建立一个基于理论的数据挖掘方法。在这些实验过程中,我们进行了随机森林占主导地位的模拟,并向数据添加了额外的维度,并通过Sharma 2011中概述的I*交互挖掘算法使用附加属性运行逻辑回归。使用具有足够数量的交互项的I*过程,可以进行逻辑回归,以匹配随机森林占主导地位的合成数据集中随机森林的性能(Sharma, 2011)。这使得交互挖掘算法以及一些最小的足够数量的交互和转换允许逻辑回归匹配集成性能。这意味着,如果数据交互中没有一定的维度,挖掘和逻辑回归就不能从交互中受益。Breiman和其他研究表明,随机森林在维度上茁壮成长,从各种数据集的经验来看,添加额外的人工维度对森林没有帮助(Breiman, 2001)。似乎存在一些最小或必要和足够的维数,超过这些维数,就不能从数据中提取更多的信息。好消息是维度可以使用icreater函数创建,该函数会自动将Tukey的重新表达式(log,负倒数和sqrt)添加到数据中。
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引用次数: 2
期刊
ERN: Discrete Regression & Qualitative Choice Models (Single) (Topic)
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