PMID: 16622356Apr 20, 2006Paper

A mathematical theory for identifying and measuring severity of episodes of care

Quality Management in Health Care
Farrokh Alemi, Samuel R Walters

Abstract

We propose and test a method for constructing episodes of care from data within administrative databases and electronic health records. We created a measure for severity of episodes of illness for 565 randomly chosen developmentally delayed children who were enrolled in the Medicaid program. Regression analysis was conducted to test the percentage of variance explained by our proposed mathematical model in cost of care. Data included both hospitalizations and clinic visits obtained from Medicaid programs from one southeastern state. For each patient, the likelihood that two diagnoses are part of the same episode is proportional to the similarity of the two diagnoses and to the short time interval between them. When this likelihood exceeds a preset cutoff, then the two diagnoses are part of the same episode. The cutoff is estimated by selecting number of days before two very similar diagnoses are considered to be part of separate episodes. The similarity between two diagnoses is assumed to be proportional to co-occurrence of the two diagnoses within a fixed period (usually 30 days). The severity of an episode was calculated using a Muliplicative Multiattribute Utility model, where severity of each diagnosis is aggregated to esti...Continue Reading

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Citations

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Nov 5, 2013·Best Practice & Research. Clinical Gastroenterology·Ron Goeree, Vakaramoko Diaby
May 24, 2013·Health Marketing Quarterly·Dean ElmutiAhmed S Abou-Zaid

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