Financial Estimation of the Uncertainty in Medicine Using Present Value of Medical Fees and a Mortality Risk Prediction Model: a Retrospective Cohort Study.

This study aimed to develop a method to enable the financial estimation of each patient's uncertainty without focusing on healthcare technology. We define financial uncertainty (FU) as the difference between an actual amount of claim (AC) and the discounted present value of the AC (DAC). DAC can be...

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Publicado en:Journal of Medical Systems Vol. 45; no. 11; pp. 1 - 13
Autores principales: Furuhata, Hiroki, Araki, Kenji, Ogawa, Taisuke
Formato: equations & formulas research tables/charts Journal Article
Publicado: Springer Nature Nov2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2021
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      pub: Springer Nature
      place: New York, New York
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        atl: Financial Estimation of the Uncertainty in Medicine Using Present Value of Medical Fees and a Mortality Risk Prediction Model: a Retrospective Cohort Study.
      aug:
        au:
          Furuhata, Hiroki
          Araki, Kenji
          Ogawa, Taisuke
        affil: Department of Hospital Institutional Research, University of Miyazaki Hospital, 5200 Kibara Kiyotake-cho, 8891692, Miyazaki, Japan
      sug:
        subj:
          Hospitalization Economics
          Health Facility Charges Evaluation
          Uncertainty Evaluation
          Hospital Mortality Risk Factors
          Risk Assessment
          Length of Stay
          Costs and Cost Analysis
          Prediction Models
          Human
          Prospective Studies
          Retrospective Design
          Record Review
          Billing and Claims
          Electronic Health Records
          Male
          Female
          Descriptive Statistics
          Japan
          Academic Medical Centers
          Inpatients Psychosocial Factors
          Scales
          Chi Square Test
          T-Tests
          Multivariate Analysis
          Univariate Statistics
          ROC Curve
          Data Analysis Software
          Male
          Female
      ab: This study aimed to develop a method to enable the financial estimation of each patient's uncertainty without focusing on healthcare technology. We define financial uncertainty (FU) as the difference between an actual amount of claim (AC) and the discounted present value of the AC (DAC). DAC can be calculated based on a discounted present value calculated using a cash flow, a period of investment, and a discount rate. The present study considered these three items as AC, the length of hospital stay, and the predicted mortality rate. The mortality prediction model was built using typical data items in standard level electronic medical records such as sex, age, and disease information. The performance of the prediction model was moderate because an area under curve was approximately 85%. The empirical analysis primarily compares the FU of the top 20 diseases with the actual AC using a retrospective cohort in the University of Miyazaki Hospital. The observational period is 5 years, from April 1, 2013, to March 31, 2018. The analysis demonstrates that the proportion of FU to actual AC is higher than 20% in low-weight children, patients with leukemia, brain tumor, myeloid leukemia, or non-Hodgkin's lymphoma. For these diseases, patients cannot avoid long hospitalization; therefore, the medical fee payment system should be designed based on uncertainty. Our method is both practical and generalizable because it uses a small number of data items that are required in standard electronic medical records. This method contributes to the decision-making processes of health policymakers.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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