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...
| Publicado en: | Journal of Medical Systems Vol. 45; no. 11; pp. 1 - 13 |
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| Autores principales: | , , |
| Formato: | equations & formulas research tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=153415574&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 153415574 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01485598 4N0 jtl: Journal of Medical Systems issn: 01485598 maglogo: N pubinfo: dt: Nov2021 vid: 45 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 153415574 153415574 153415574 10.1007/s10916-021-01775-y 153415574 ppf: 1 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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