The distribution of health care payments to insurance plans has substantial consequences for social policy. Risk adjustment formulas predict spending in health insurance markets in order to provide fair benefits and health care coverage for all enrollees, regardless of their health status. Unfortunately, current risk a…
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48 results for “health care spending”
Inpatient care is a large share of total health care spending, making analysis of inpatient utilization patterns an important part of understanding what drives health care spending growth. Common features of inpatient utilization measures include zero inflation, over-dispersion, and skewness, all of which complicate st…
Estimates causal effect of managed care plans on NYC Medicaid spending.
problem Generalizing causal estimates to a target population not well-represented by randomized studies.
method Conditional cross-design synthesis estimators combining randomized and observational data.
result Estimates causal effect of managed care plans on health care spending.
LHIEM model predicts health, income, and employment over years.
problem Lack of path dependency in health policy simulations.
method Discrete-time microsimulation with Markov chain modules.
result Validates health care financing proposal through detailed modeling.
Study finds macroeconomic indicators predict health workforce and infrastructure measures.
problem Evaluating the predictive value of macroeconomic indicators for public health targets.
method Examined multiple forecasting approaches including neural networks, generalized additive models, random forests, and time series models with exogenous indicators.
result Macroeconomic indicators provide consistent and reproducible predictive signals for health workforce and infrastructure measures, but less so for other targets.
LMM predicts healthcare costs and risks with improved accuracy.
problem Wasteful healthcare spending and inefficiencies in risk prediction.
method Generative pre-trained transformer trained on patient event sequences.
result Improves cost prediction by 14.1% and chronic conditions prediction by 1.9%.
Italy and the Eurozone are heading in the year 2012 into a financial depression of unprecedented magnitude, with a forthcoming multitude of often contradictory public economic and financial stability emergency interventions whose ultimate endogenous and exogenous effects on public and private health spending and on the…
Model predicts COVID-19 growth in Senegal, highlighting health care capacity importance.
problem Impact of health care capacity on COVID-19 growth in Senegal.
method Compartmental model with logistic growth health care capacity, machine learning projection.
result Condition to avoid overwhelming health care system provided.
New AI model optimizes personalized care for elderly residents.
problem Limited care workforce impacts health outcomes and quality of life.
method Bandit algorithms for personalized care planning.
result Improves care quality and health outcomes through personalized care planning.
Study on privacy-preserving health care models that sacrifice accuracy for data protection.
problem Privacy-preserving models in health care neglect data from the tails, reducing accuracy for small groups.
method Used state-of-the-art differentially private learning methods for clinical prediction tasks.
result Privacy-preserving models in health care exhibit steep tradeoffs between privacy and utility, and disproportionately influence large demographic groups.
Develops a personalized reinforcement learning algorithm for dyadic health interventions.
problem Personalizing health interventions for dyadic relationships in mobile health.
method Dyadic Reinforcement Learning (dyadic RL), a Bayesian and hierarchical online algorithm.
result Established a regret bound and demonstrated empirical performance through simulations and real data.
Bayesian model identifies health disparities in disease progression.
problem Health disparities bias disease progression models.
method Interpretable Bayesian model accounting for three disparities.
result Model identifies and corrects for health disparities.
Study shows racial bias in health data, which can be reduced with simple techniques.
problem Racial bias in health indicators measured by the Medical Expenditure Panel Survey (MEPS).
method Used publicly available and nationally representative MEPS data to show bias in predictive models for care management.
result Racial bias can be significantly reduced using simple mitigation techniques.
The paper improves decision tree stability for health care applications.
problem Stability of decision trees in health care applications.
method Introducing a new distance metric to determine tree stability and proposing a novel training methodology.
result On average, a 4.6% decrease in predictive power yields a 38% increase in model stability.
This study compares community detection algorithms for delineating health service areas.
problem Delineating health service areas to improve health care services.
method Comparative analysis of community detection algorithms on hospital-patient discharge networks.
result Infomap algorithm produced the best delineation of health service areas.
Study assesses health plan risk measures for Solvency Capital Requirement.
problem Assessing risk measures for health plans to meet Solvency Capital Requirement.
method Three-part regression model with three GLMs for claim counts, episode allocation, and severity.
result Reduction in regression models compared to traditional methods.
System predicts HIV patients at risk of dropping out of care.
problem High non-adherence and dropout rates among HIV patients.
method Predictive machine learning model based on resource constraints, stability, and fairness.
result Model performs 3x better than baseline for clinical use and 2.3x better for city-wide use.
In this paper we introduce score embedding, a neural network based model to learn interpretable vector representations for words. Score embedding is a supervised method that takes advantage of the labeled training data and the neural network architecture to learn interpretable representations for words. Health care has…
The health outcomes of high-need patients can be substantially influenced by the degree of patient engagement in their own care. The role of care managers includes that of enrolling patients into care programs and keeping them sufficiently engaged in the program, so that patients can attain various goals. The attainmen…
Enhances patient failure prediction using dynamic survival models.
problem Lack of precise individual level prediction in conventional models.
method Developed counterfactual dynamic survival model (CDSM).
result Inflection point of estimated survival curves predicts patient failure time.
Model predicts wound and episode-level readmission risk and time to re-admit.
problem Identify patients at high risk of re-admission to prevent wound recurrences and reduce healthcare costs.
method Data-driven analysis of wound care and episode-level patient data.
result Model achieves high recall and precision for predicting re-admission risk and time.
Applying machine learning in the health care domain has shown promising results in recent years. Interpretable outputs from learning algorithms are desirable for decision making by health care personnel. In this work, we explore the possibility of utilizing causal relationships to refine diagnostic prediction. We focus…
Two machine learning models detect anomalies in ER claims, saving up to 40% in improper payments.
problem Improper health insurance payments from fraud and upcoding.
method Two machine learning models: an upcoding model based on severity code distributions and a random forest model for claim sorting.
result Random forest model saved 12% to 40% in improper payments compared to a baseline approach.
Improved TF-IDF for word relevance in health-care social media documents.
problem Determining word relevance in informal documents.
method Semantic Sensitive TF-IDF (STF-IDF) method.
result Decreased TF-IDF mean error rate by 50% to 13.7%.
Mobile apps and machine learning improve malaria prevention and treatment.
problem High malaria cases and deaths in low-income countries.
method Adaptive interventions using mobile health apps and machine learning.
result Increased malaria testing, adherence, and provider skills.
Clinical data for ambulatory care, which accounts for 90% of the nations healthcare spending, is characterized by relatively small sample sizes of longitudinal data, unequal spacing between visits for each patient, with unequal numbers of data points collected across patients. While deep learning has become state-of-th…
The International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) is a scaffold for designating and systematizing data on functioning and disability. It offers a standard semantic and a theoretical foundation for the demarcation and extent of wellbeing and infirmity. The multidimen…
The occurrence of drug-drug-interactions (DDI) from multiple drug dispensations is a serious problem, both for individuals and health-care systems, since patients with complications due to DDI are likely to reenter the system at a costlier level. We present a large-scale longitudinal study (18 months) of the DDI phenom…
Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, recorded in electronic medical records, are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network t…
Bedside monitors in Intensive Care Units (ICUs) frequently sound incorrectly, slowing response times and desensitising nurses to alarms (Chambrin, 2001), causing true alarms to be missed (Hug et al., 2011). We compare sliding window predictors with recurrent predictors to classify patient state-of-health from ICU multi…
A new model improves homogeneity in burn patient reimbursement.
problem Incomplete homogeneity checks for burn patients using LOS as a proxy.
method Cost-sensitive decision tree model considering patient-level cost and severity of burn.
result Identified groups with increased homogeneity compared to current HRG groups.
Community-based Question Answering (CQA) sites play an important role in addressing health information needs. However, a significant number of posted questions remain unanswered. Automatically answering the posted questions can provide a useful source of information for online health communities. In this study, we deve…
Interpretable Identification of Comorbidities Associated with Recurrent ED and Inpatient Visitsstat.ML
Framework identifies comorbidities for frequent ED and inpatient visits.
problem Reducing resource usage and costs in frequent patients.
method Developed MSAR algorithm to identify comorbidities.
result MSAR identifies conditions most associated with reoccurring ED and inpatient visits.
A Longitudinal Attribute-Conditioned Neural Network (LANTERN) framework for modeling health-state transition probabilities in irregular longitudinal data.
problem Estimating long-term care transition probabilities in irregular longitudinal health data.
method A neural network that learns from individual health history, incorporates time elapsed, and conditions on demographic and socioeconomic attributes.
result Improves severe disability discrimination and maintains strong calibration.
Models for predicting the risk of cardiovascular events based on individual patient characteristics are important tools for managing patient care. Most current and commonly used risk prediction models have been built from carefully selected epidemiological cohorts. However, the homogeneity and limited size of such coho…
Survey reviews explainability in AI for healthcare, emphasizing trust and transparency.
problem Lack of transparency hinders AI adoption in healthcare.
method Comprehensive literature review to guide explainable AI design.
result Quantitative evaluation metrics are needed for some explainability properties.
Proposes GLWB-LTC for enhanced life care annuities with dynamic withdrawal strategies and stochastic interest rates.
problem Improving life care annuity features and pricing methods.
method Introduces GLWB-LTC with dynamic withdrawal strategies and stochastic interest rates. Solves the stochastic control problem using a robust tree method.
result Optimal withdrawal strategies vary over time with policyholder's health status, highlighting the advantage of flexibility.
Health care is one of the most exciting frontiers in data mining and machine learning. Successful adoption of electronic health records (EHRs) created an explosion in digital clinical data available for analysis, but progress in machine learning for healthcare research has been difficult to measure because of the absen…
A latent topic model for mining heterogenous non-randomly missing electronic health records datacs.LG
Electronic health records (EHR) are rich heterogeneous collection of patient health information, whose broad adoption provides great opportunities for systematic health data mining. However, heterogeneous EHR data types and biased ascertainment impose computational challenges. Here, we present mixEHR, an unsupervised g…
New fair regression method improves fairness in chronic kidney disease classification.
problem Mitigating societal bias in health care for multiple groups.
method Penalized fair regression framework for multiple groups, with penalties for true positive rate disparity.
result Achieves fairness-accuracy frontier beyond existing methods in simulations and real-world data.
When training clinical prediction models from electronic health records (EHRs), a key concern should be a model's ability to sustain performance over time when deployed, even as care practices, database systems, and population demographics evolve. Due to de-identification requirements, however, current experimental pra…
A Self-Attention Network for Hierarchical Data Structures with an Application to Claims Managementcs.LG
Insurance companies must manage millions of claims per year. While most of these claims are non-fraudulent, fraud detection is core for insurance companies. The ultimate goal is a predictive model to single out the fraudulent claims and pay out the non-fraudulent ones immediately. Modern machine learning methods are we…
Predicting Length of Stay in the Intensive Care Unit with Temporal Pointwise Convolutional Networkscs.LG
New model predicts ICU patients' stay duration efficiently.
problem Efficient ICU bed allocation under resource constraints.
method Temporal Pointwise Convolution (TPC) model combining temporal and pointwise convolutions.
result Significant performance improvements over LSTM and Transformer models.
The huge wealth of data in the health domain can be exploited to create models that predict development of health states over time. Temporal learning algorithms are well suited to learn relationships between health states and make predictions about their future developments. However, these algorithms: (1) either focus …
Deep neural network predicts health costs better than traditional models.
problem Accurate prediction of healthcare costs for optimal cost management.
method Developed a deep neural network to predict future health care costs from health insurance claims records.
result Deep neural network outperformed ridge regression and Morbi-RSA models in cost prediction.
HOLMES improves real-time model serving for ICU patients, balancing accuracy and speed.
problem Real-time model serving is crucial in ICU due to urgency and cost.
method Online model ensemble serving framework for healthcare applications.
result HOLMES achieves high accuracy and sub-second latency for model ensemble serving.
Improving the quality of end-of-life care for hospitalized patients is a priority for healthcare organizations. Studies have shown that physicians tend to over-estimate prognoses, which in combination with treatment inertia results in a mismatch between patients wishes and actual care at the end of life. We describe a …
Accurate classification of self-care problems in children who suffer from physical and motor affliction is an important problem in the healthcare industry. This is a difficult and a time consumming process and it needs the expertise of occupational therapists. In recent years, healthcare professionals have opened up to…