scholarly journals Cost Control of Treatment for Cerebrovascular Patients Using a Machine Learning Model in Western China

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Siyu Zeng ◽  
Li Luo ◽  
Yuanchen Fang ◽  
Xiaozhou He
Keyword(s):  
Cerebrovascular Disease ◽  
Diagnosis Related Groups ◽  
Medical Expenditure ◽  
Western China ◽  
Concomitant Disease ◽  
Tree Model ◽  
Related Data ◽  
Chi Squared ◽  
Rule Sets ◽  
The Government

Background. Cerebrovascular disease has been the leading cause of death in China since 2017, and the control of medical expenses for these diseases is an urgent issue. Diagnosis-related groups (DRG) are increasingly being used to decrease the costs of healthcare worldwide. However, the classification variables and rules used vary from region to region. Of these variables, the question of whether the length of stay (LOS) should be used as a grouping variable is controversial. Aim. To identify the factors influencing inpatient medical expenditure in cerebrovascular disease patients. The performance of two sets of classification rules, and the effects of the extent of control of unreasonable medical treatment, were compared, to investigate whether the classification variables should include LOS. Methods. Data from 45,575 inpatients from a Healthcare Security Administration of a city in western China were used. Kruskal–Wallis H tests were used for single-factor analysis, and multiple linear stepwise regression was used to determine the main factors. A chi-squared automatic interaction detector (CHAID) algorithm was built as a decision tree model for grouping related data. The intensity of oversupply of service was controlled step by step from 10% to 100%, and the performance was calculated for each group. Results. The average hospitalization cost was 1,284 US dollars, and the total was 51.17 million US dollars. Of this, 43.42 million were paid by the government, and 7.75 million were paid by individuals. Factors including gender, age, type of insurance, level of hospital, LOS, surgery, therapeutic outcomes, main concomitant disease, and hypertension significantly influenced inpatient expenditure ( P < 0.05 ). Incorporating LOS, the patients were divided into seven DRG groups, while without LOS, the patients were divided into eight DRG groups. More clinical variables were needed to achieve good results without LOS. Of the two rule sets, smaller coefficient of variation (CV) and a lower upper limit for patient costs were found in the group including LOS. Using this type of economic control, 3.35 million US dollars could be saved in one year.

scholarly journals A study on the incidence of tuberculosis in Narail district of Bangladesh

Mediscope ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. 12-15
Author(s):  
MS Mallick
Keyword(s):  
Control Program ◽  
Situational Analysis ◽  
Pulmonary Tb ◽  
Tb Control ◽  
Related Data ◽  
Number Of Patients ◽  
Case Rate ◽  
Extra Pulmonary ◽  
The Government ◽  
Tb Control Program

The aim of this descriptive type of study on diagnosed tuberculosis (TB) cases was to evaluate the incidence of TB in Narail district to have a situational analysis with the achievement of National TB Control Program. Related data were collected from the Civil Surgeon Office, Narail district. The data of 3 upazilas- Narail Sadar, Kalia, and Lohagora were used. The study period was from January 1, 2016 to December 31, 2016. The overall TB case rate was 156.6 per 100000 population and separately 170.9 per 100000 population in Narail Sadar, 142.2 per 100000 population in Kalia and 156.6 per 100000 population in Lohagora. Of the cases, 56.4% were male and 43.6% female. Overall, 89.7% of the TB cases had pulmonary TB and 10.3% had extra-pulmonary TB. The population with higher age had higher proportion having TB. The highest number of patients were referred for diagnosis by sastha sebika (nurse) and non-government field staff. The TB incidence in Narail district was considered to be lower than the National situation. However, it seems that TB will remain as a continuous concern for many years in future for the country as well as Narail district. The activities of National TB Control Program of the Government of Bangladesh needs to be strengthened further to combat TB in BangladeshMediscope Vol. 5, No. 2: Jul 2018, Page 12-15

scholarly journals Should rapid antigen tests be government funded in Australia? An economic evaluation

2022 ◽  
Author(s):  
Jonathan Karnon
Keyword(s):  
Decision Tree ◽  
Input Parameter ◽  
Decision Tree Model ◽  
Tree Model ◽  
Public Health Response ◽  
Detection Rates ◽  
The Public ◽  
Scenario Analyses ◽  
The Government ◽  
Antigen Tests

Objective: Easy and equitable access to testing is a cornerstone of the public health response to COVID-19. Currently in Australia, testing using Polymerase Chain Reaction (PCR) tests for COVID-19 is free-to-the-user, but the public purchase their own Rapid Antigen Tests (RATs). We conduct an economic analysis of government-funded RATs in Australia. Design: An interactive decision tree model was developed to compare one policy in which government-funded RATs are free-to-the-user, and one in which individuals purchase their own RATs. The decision tree represents RAT and PCR testing pathways for a cohort of individuals without COVID-19-like symptoms, to estimate the likelihood of COVID-19 positive individuals isolating prior to developing symptoms and the associated costs of testing, from a government perspective. Data sources: Test costs and detection rates were informed by published studies, other input parameter values are unobservable and uncertain, for which a range of scenario analyses are presented. Data synthesis: Assuming 10% prevalence of COVID-19 in a cohort of 10,000 individuals who would use government-funded RATs, the model estimates an additional 464 individuals would isolate early at a cost to the government of around $52,000. Scenario analyses indicate that the incremental cost per additional COVID-19 positive individual isolating with no symptoms remains at a few hundred dollars at 5% prevalence, rising to $2,052 at 1% prevalence. Conclusions: Based on the presented decision tree model, even only minor reductions in COVID-19 transmission rates due to early isolation would justify the additional costs associated with a policy of government-funded RATs.

scholarly journals Determination of Climate and Social Community Factors in Coronavirus Disease-19 Spread Distribution

2021 ◽  
Vol 9 (E) ◽  
pp. 1434-1442
Author(s):  
Faradiba Faradiba ◽  
Lodewik Zet
Keyword(s):  
Growth Rate ◽  
Analysis Method ◽  
Daily Growth ◽  
Social Community ◽  
Community Factors ◽  
Chi Squared ◽  
The Government ◽  
Automatic Interaction Detector

BACKGROUND: Coronavirus Disease-2019 (COVID-19) is very shocking to the world. Until mid-2020, this virus has not yet found a vaccine that can be produced and can be applied en mass across the country. The spread of COVID-19 differs between regions which implie that regional characteristics have an influence on the rate of growth. Regional and social climate factors are thought to have a role in the growth rate of COVID-19. AIM: This study aims to find the role of climate and social society on the spread of COVID-19. METHODS: This research uses OLS regression analysis method, and then continued with Chi-squared Automatic Interaction Detector analysis to find the segmentation of the role of climate and social factors on the daily growth rate of COVID-19 in positive and deceased patients. RESULTS: The results of this study state that all independent variables of the study have a significant effect on the spread of COVID-19, with R-squared values in positive and deceased patients, respectively 61.1% and 70.0%. Strategic steps are needed to carry out policies that are targeted, effective and efficient. CONCLUSION: The results of this study can be a reference for the government in determining policies to reduce the growth rate of COVID-19, by focusing on areas that have poor sanitary environment and area are on Java Island.

Intelligent System for Credit Risk Management in Financial Institutions

2019 ◽  
Vol 9 (2) ◽  
pp. 57-67
Author(s):  
Philip Sarfo-Manu ◽  
Gifty Siaw ◽  
Peter Appiahene
Keyword(s):  
Credit Risk ◽  
Financial Institutions ◽  
Intelligent System ◽  
Subjective Assessment ◽  
Bank Loan ◽  
Credit Risk Management ◽  
Tree Model ◽  
Assessment And Evaluation ◽  
Employment Sector ◽  
The Government

Credit crunch is an alarming challenge facing financial institutions in Ghana due to their inability to manage credit risk. Failure to manage credit risk may lead to customers defaulting and institutions becoming bankrupt, making it a major concern for financial institutions and the government. The assessment and evaluation of loan applications based on a loan officer's subjective assessment and human judgment is inefficient, inconsistent, non-uniform, and time consuming. Therefore, a knowledge discovery tool is required to help in decision making regarding the approval of loan application. The aim of this project is to develop an intelligent system based on a decision tree model to manage credit risk. Data was obtained from the bank loan histories. The data is comprised of four hundred observations with seven variables: client age, amount requested, dependents, collateral value, employment sector, employment type, and results. The results of study suggest that the proposed system can be used to predict client eligibility for loans with an accuracy rate of 70%.

scholarly journals Improving Monitoring and Water Point Functionality in Rural Ethiopia

Water ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1591 ◽  
Author(s):  
Carmen Anthonj ◽  
Lisa Fleming ◽  
Ryan Cronk ◽  
Samuel Godfrey ◽  
Argaw Ambelu ◽  
...  
Keyword(s):  
Management Practices ◽  
Water Pressure ◽  
Monitoring And Evaluation ◽  
Cross Sectional ◽  
Knowledge To Action ◽  
Related Data ◽  
Rural Ethiopia ◽  
Community Water ◽  
Water Point ◽  
The Government

This study examines the patterns, trends, and factors associated with functional community water points in rural Ethiopia and identifies potential areas of improvement in terms of practitioner response to functionality and functionality monitoring. It was part of an integrated WaSH and nutrition program implemented by UNICEF Ethiopia and the Government of Ethiopia. Cross-sectional surveys were conducted to collect WaSH-related data in communities and WaSH committees from four community-based nutrition (CBN) program groupings in Ethiopia. In all areas, CBN was implemented, but only in less than half of the areas, a WaSH intervention was implemented. Seventy-three representative kebeles, comprising 30 intervention and 43 control communities, were surveyed. Two structured surveys were conducted. The ‘community survey’ addressed community water points and their functionality and the main areas for improvement needed. The ‘WaSH committee survey’ investigated technical and management aspects of water points and their functionality. Data were analyzed using bivariate regression to identify community characteristics and management practices associated with functionality of water points and explore opportunities to improve water point functionality and monitoring. In the communities, 65% of water points were functional. Eighty percent of communities had a WaSH committee. The WaSH committee members reported that the most used water point types were protected dug wells and boreholes, and that 80% of their water points were functional. India Mark II pumps were more likely to be functional and communities with longer established WaSH committees had higher water point functionality. Communities suggested that the key factors for water point sustainability were improving water quality and water pressure, reducing water collection time, and speeding up repair times. Taking community leaders’ ‘priority lists’ into consideration offers sustainable opportunities for demand-driven, adaptive and targeted design and implementation of rural water supply programs, which, if they include the grassroots level as key informants and actors of change, can succeed. Interventions should integrate the ‘voice’ of the community, the WaSH committees, and other stakeholders and thereby facilitate transdisciplinary approaches at different stages of program management (planning, monitoring, and evaluation). This would help closing the knowledge to action gap and improve policy, programming, practice, and service delivery.

scholarly journals Clinical Performance of Lithium Disilicate Glass-Ceramic Onlays For The Treatment of Tooth Defects

2021 ◽  
Author(s):  
Shujiang Chen ◽  
Meng Lu ◽  
Zhimin Zhu ◽  
Wenchuan C. Chen
Keyword(s):  
Survival Rate ◽  
Glass Ceramic ◽  
Clinical Performance ◽  
United States Public Health ◽  
Lithium Disilicate ◽  
Western China ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Chi Squared

Abstract BackgroundThe aim of this study was to assess the clinical performance of lithium disilicate glass-ceramic onlays for the treatment of tooth defects and to evaluate the clinical performance and whether they are worth more extensive use as that of the full crown. MethodsPatients who received treatment by lithium disilicate glass-ceramic onlays at the Western China Hospital of Stomatology were recalled after 1~4 years. The clinical performance and patients’ satisfaction of onlays for various tooth defects, cracked or uncracked teeth and endodontically treated or vital teeth were retrospectively evaluated with a combination of modified United States Public Health Service Criteria and questionnaire survey. Statistical analysis was performed by using the chi-squared test, Kaplan–Meier analysis and Log-rank test (a = 0.05) where appropriate. ResultsA total of 154 patients with 166 onlays were recalled for clinical examination. Of the 166 onlays examined, 65 (39.19%) were occlusal onlays, 92 (55.42%) were proximal-occlusive onlays and 9 (5.42%) were buccal-or lingual-occlusal onlays. The clinical performance of O and PO onlays was not significantly different (P > 0.05), according to USPHS Criteria. Kaplan-Meier analysis showed that the 4-year survival rate of O and PO onlays was 95.4% and 97.8%, respectively while there was no failure happened in buccal-or lingual-occlusal onlays. Log- rank test showed that the kinds of defects/onlays, tooth vitality and tooth crack had no influence on the survival rate (P > 0.05). The overall satisfaction rate was more than 98%.ConclusionsThis medium-term analysis indicated that lithium disilicate glass-ceramic onlays achieved satisfactory clinical performance for the restoration of different tooth defects. The survival rate of onlays was comparable to that of full crown. Different kinds of tooth defects, tooth vitality and tooth crack did not influence performance.Trial registrationThe study was approved by the Medical Ethics Committee of West China Hospital of Stomatology of Sichuan University with the approval number: WCHSIRB-D-2021-300. Consent to participate was not applicable.

scholarly journals Decoupling of Elderly Healthcare Demand and Expenditure in China

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1346
Author(s):  
Shangguang Yang ◽  
Danyang Wang ◽  
Wenhui Li ◽  
Chunlan Wang ◽  
Xi Yang ◽  
...  
Keyword(s):  
Health Insurance ◽  
Elderly Population ◽  
The Elderly ◽  
Health Condition ◽  
Medical Expenditure ◽  
Linear Regression Models ◽  
Healthy Longevity ◽  
The Government ◽  
Elderly Healthcare ◽  
Significant Factors

This study examined the changing trajectory and factors that influenced the health and medical expenditure of the Chinese elderly population over the past two decades. Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 1998 to 2018, inferential and multiple linear regression models were constructed. The key finding is that China has experienced a decoupling of healthcare demand (HCD) and healthcare expenditure (HCE) since around 2014, when HCE began to decline despite the fact that HCD continued to rise. This is a promising sign, suggesting that the government’s health insurance policy is working. Furthermore, participating in health insurance schemes can significantly reduce the elderly’s HCD and HCE, demonstrating that health insurance can effectively affect the elderly’s decision to seek medical treatment and improve their health condition. We also found that age, region, basic old-age insurance, and care by the government and institutions were significant factors that influenced the healthcare demand and expenditure of the elderly population.

scholarly journals How to improve the satisfaction levels of new rural cooperative medical system in underdeveloped areas of China?

2020 ◽  
Author(s):  
Pin Yao ◽  
Yifan Wu ◽  
Xiaodong Chen ◽  
Jing Ouyang ◽  
Chunping Liu ◽  
...  
Keyword(s):  
Medical Service ◽  
Economic Security ◽  
Medical System ◽  
Western China ◽  
Western Region ◽  
Willingness To Participate ◽  
Government Investment ◽  
Medical Institutions ◽  
The Western Region ◽  
The Government

Abstract Background: Over the years, China has designed a new rural cooperative medical system for large rural population, which enables them to obtain adequate medical services and prevents poverty caused by medical treatments. However, the rapid economic growth makes the allocation of health resources and the efficient utilization of health services face severe challenges. The study aims to reveal the medical inequality of eight underdeveloped provinces from the perspectives of medical institutions, insurance policies, the government and farmers, in order to puts forward relevant recommendations.Methods: The relevant statistics about assessing the characteristics and equity of demographics, socio-economic and geographical dimensions were from the China Statistical Yearbook and the China Health Statistics Yearbook. A face-to-face sampling survey of farmers in 24 counties of eight less developed provinces (Guizhou, Yunnan, Sichuan, Shanxi, Gansu, Qinghai, Ningxia and Xinjiang) was carried out by multi-stage stratified random sampling. The protection effect of New Rural Cooperative Medical System（NRCMS）, satisfaction of medical service and willingness to participate in NRCMS were analyzed.Results: Since the implementation of the new rural cooperative medical system, there has been an inequality in medical service and insurance policy among poor residents in western China. The uneven distribution of medical resources, the inadequacy of local government investment, the complexity of the reimbursement process, and the low amount of compensation resulted in only 26.6% of the population believing that the economic burden of the disease had been reduced, and 57.3% that the relief effect was not obvious. The remaining 16.1% thought the system was ineffective and farmers' satisfaction was not enough. Conclusion: Compared with the eastern and central regions, there was a certain degree of unfairness in government investment in the resources of medical institutions of the western region with new rural cooperative medical care. This study suggested that policy makers can attract high-quality medical staff to the western region by providing economic security and improving policies. In addition, the increase of the government regional health expenditure and supervision propaganda was one of the important ways to improve the farmers' satisfaction with the policy.

scholarly journals Does Industrial Air Pollution Increase Health Care Expenditure? Evidence From China

2021 ◽  
Vol 9 ◽  
Author(s):  
Jin-Sheng Shen ◽  
Qun Wang ◽  
Han-Pu Shen
Keyword(s):  
Health Care ◽  
Air Pollution ◽  
Health Care Expenditure ◽  
Random Effect ◽  
Random Effect Model ◽  
Medical Expenditure ◽  
Added Value ◽  
Western China ◽  
Effect Model ◽  
The Impact

This paper discusses the impact of air pollution on medical expenditure in eastern, central, and western China by applying the fixed-effect model, random-effect model, and panel threshold regression model. According to theoretical and empirical analyses, there are different relationships between the two indexes in different regions of China. For eastern and central regions, it is obvious that the more serious the air pollution is, the more medical expenses there are. However, there is a non-linear single threshold effect between air pollution and health care expenditure in the western region. When air pollution is lower than this value, there is a negative correlation between them. Conversely, the health care expenditure increases with the aggravation of air pollution, but the added value is not enough to make up for the health problems caused by air pollution. The empirical results are basically consistent with the theoretical analysis, which can provide enlightenment for the government to consider the role of air pollution in medical expenditure. Policymakers should arrange the medical budget reasonably, according to its situation, to make up for the loss caused by air pollution.

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