Predictive modeling to identify potential participants of a disease management program hypertension.


Journal

Expert review of pharmacoeconomics & outcomes research
ISSN: 1744-8379
Titre abrégé: Expert Rev Pharmacoecon Outcomes Res
Pays: England
ID NLM: 101132257

Informations de publication

Date de publication:
Apr 2021
Historique:
pubmed: 1 7 2020
medline: 29 4 2021
entrez: 1 7 2020
Statut: ppublish

Résumé

Based on the premise of limited health-care resources, decision-makers pursue to allocate disease management programs (DMP) more targeted. Based on routine data from a private health insurance company, a prediction model was developed to estimate the individual risk for future in-patient stays of patients eligible for a DMP Hypertension. The database included anonymous claims data of 38,284 policyholders with a diagnosis in the year 2013. A cutoff point of ≥70% was used for selecting candidates with a risk for future hospitalization. Using a logistic regression model, we estimated the model's prognostic power, the occurrence of clinical events, and the resource use. Overall, the final model shows acceptable prognostic power (detection rate = 64.3%; sensitivity = 68.7%; positive predictive value (PPV) = 64.1%, area under the curve (AUC) = 0.72). The comparison between the selected hypothetical DMP-group with a predicted (LOH) ≥70% showed additional costs of about 69% for the DMP-group compared to insure with a LOH <70%. The predictive analytical approach may identify potential DMP participants with a high risk of increased health services utilization and in-patient stays.

Sections du résumé

BACKGROUND BACKGROUND
Based on the premise of limited health-care resources, decision-makers pursue to allocate disease management programs (DMP) more targeted.
METHODS METHODS
Based on routine data from a private health insurance company, a prediction model was developed to estimate the individual risk for future in-patient stays of patients eligible for a DMP Hypertension. The database included anonymous claims data of 38,284 policyholders with a diagnosis in the year 2013. A cutoff point of ≥70% was used for selecting candidates with a risk for future hospitalization. Using a logistic regression model, we estimated the model's prognostic power, the occurrence of clinical events, and the resource use.
RESULTS RESULTS
Overall, the final model shows acceptable prognostic power (detection rate = 64.3%; sensitivity = 68.7%; positive predictive value (PPV) = 64.1%, area under the curve (AUC) = 0.72). The comparison between the selected hypothetical DMP-group with a predicted (LOH) ≥70% showed additional costs of about 69% for the DMP-group compared to insure with a LOH <70%.
CONCLUSION CONCLUSIONS
The predictive analytical approach may identify potential DMP participants with a high risk of increased health services utilization and in-patient stays.

Identifiants

pubmed: 32600073
doi: 10.1080/14737167.2020.1780919
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

307-314

Auteurs

Pamela Lenti (P)

Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Germany.

Stefan Kottmair (S)

Institute of Health, Technical University of Rosenheim, Germany.

Stephanie Stock (S)

Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Germany.

Arim Shukri (A)

Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Germany.

Dirk Müller (D)

Institute for Health Economics and Clinical Epidemiology, University Hospital of Cologne, Germany.

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