scholarly journals Forecasting Future Asthma Hospital Encounters of Patients With Asthma in an Academic Health Care System: Predictive Model Development and Secondary Analysis Study (Preprint)

2020 ◽  
Author(s):  
Yao Tong ◽  
Amanda I Messinger ◽  
Adam B Wilcox ◽  
Sean D Mooney ◽  
Giana H Davidson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Secondary Analysis ◽  
Academic Health ◽  
Machine Learning Model ◽  
Care Systems ◽  
Intermountain Healthcare ◽  
Modeling Strategy ◽  
Care System

BACKGROUND Asthma affects a large proportion of the population and leads to many hospital encounters involving both hospitalizations and emergency department visits every year. To lower the number of such encounters, many health care systems and health plans deploy predictive models to prospectively identify patients at high risk and offer them care management services for preventive care. However, the previous models do not have sufficient accuracy for serving this purpose well. Embracing the modeling strategy of examining many candidate features, we built a new machine learning model to forecast future asthma hospital encounters of patients with asthma at Intermountain Healthcare, a nonacademic health care system. This model is more accurate than the previously published models. However, it is unclear how well our modeling strategy generalizes to academic health care systems, whose patient composition differs from that of Intermountain Healthcare. OBJECTIVE This study aims to evaluate the generalizability of our modeling strategy to the University of Washington Medicine (UWM), an academic health care system. METHODS All adult patients with asthma who visited UWM facilities between 2011 and 2018 served as the patient cohort. We considered 234 candidate features. Through a secondary analysis of 82,888 UWM data instances from 2011 to 2018, we built a machine learning model to forecast asthma hospital encounters of patients with asthma in the subsequent 12 months. RESULTS Our UWM model yielded an area under the receiver operating characteristic curve (AUC) of 0.902. When placing the cutoff point for making binary classification at the top 10% (1464/14,644) of patients with asthma with the largest forecasted risk, our UWM model yielded an accuracy of 90.6% (13,268/14,644), a sensitivity of 70.2% (153/218), and a specificity of 90.91% (13,115/14,426). CONCLUSIONS Our modeling strategy showed excellent generalizability to the UWM, leading to a model with an AUC that is higher than all of the AUCs previously reported in the literature for forecasting asthma hospital encounters. After further optimization, our model could be used to facilitate the efficient and effective allocation of asthma care management resources to improve outcomes. INTERNATIONAL REGISTERED REPORT RR2-10.2196/resprot.5039

scholarly journals Forecasting Future Asthma Hospital Encounters of Patients With Asthma in an Academic Health Care System: Predictive Model Development and Secondary Analysis Study

10.2196/22796 ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. e22796
Author(s):  
Yao Tong ◽  
Amanda I Messinger ◽  
Adam B Wilcox ◽  
Sean D Mooney ◽  
Giana H Davidson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Secondary Analysis ◽  
Academic Health ◽  
Machine Learning Model ◽  
Care Systems ◽  
Intermountain Healthcare ◽  
Modeling Strategy ◽  
Care System

Background Asthma affects a large proportion of the population and leads to many hospital encounters involving both hospitalizations and emergency department visits every year. To lower the number of such encounters, many health care systems and health plans deploy predictive models to prospectively identify patients at high risk and offer them care management services for preventive care. However, the previous models do not have sufficient accuracy for serving this purpose well. Embracing the modeling strategy of examining many candidate features, we built a new machine learning model to forecast future asthma hospital encounters of patients with asthma at Intermountain Healthcare, a nonacademic health care system. This model is more accurate than the previously published models. However, it is unclear how well our modeling strategy generalizes to academic health care systems, whose patient composition differs from that of Intermountain Healthcare. Objective This study aims to evaluate the generalizability of our modeling strategy to the University of Washington Medicine (UWM), an academic health care system. Methods All adult patients with asthma who visited UWM facilities between 2011 and 2018 served as the patient cohort. We considered 234 candidate features. Through a secondary analysis of 82,888 UWM data instances from 2011 to 2018, we built a machine learning model to forecast asthma hospital encounters of patients with asthma in the subsequent 12 months. Results Our UWM model yielded an area under the receiver operating characteristic curve (AUC) of 0.902. When placing the cutoff point for making binary classification at the top 10% (1464/14,644) of patients with asthma with the largest forecasted risk, our UWM model yielded an accuracy of 90.6% (13,268/14,644), a sensitivity of 70.2% (153/218), and a specificity of 90.91% (13,115/14,426). Conclusions Our modeling strategy showed excellent generalizability to the UWM, leading to a model with an AUC that is higher than all of the AUCs previously reported in the literature for forecasting asthma hospital encounters. After further optimization, our model could be used to facilitate the efficient and effective allocation of asthma care management resources to improve outcomes. International Registered Report Identifier (IRRID) RR2-10.2196/resprot.5039

scholarly journals Unmasking a health care system: the Dutch policy response to the Covid-19 crisis

2021 ◽  
pp. 1-10 ◽  
Author(s):  
Iris Wallenburg ◽  
Jan-Kees Helderman ◽  
Patrick Jeurissen ◽  
Roland Bal
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care System ◽  
Health Care Systems ◽  
Economic Policies ◽  
Hard Time ◽  
Dutch Health ◽  
Care Systems ◽  
Policy Systems ◽  
Care System

Abstract The Covid-19 pandemic has put policy systems to the test. In this paper, we unmask the institutionalized resilience of the Dutch health care system to pandemic crisis. Building on logics of crisis decision-making and on the notion of ‘tact’, we reveal how the Dutch government initially succeeded in orchestrating collective action through aligning public health purposes and installing socio-economic policies to soften societal impact. However, when the crisis evolved into a more enduring one, a more contested policy arena emerged in which decision-makers had a hard time composing and defending a united decision-making strategy. Measures have become increasingly debated on all policy levels as well as among experts, and conflicts are widely covered in the Dutch media. With the 2021 elections ahead, this means an additional test of the resilience of the Dutch socio-political and health care systems.

scholarly journals Implementation of low-dose CT screening in two different health care systems: Mount Sinai Healthcare System and Phoenix VA Health Care System

2021 ◽  
Vol 10 (2) ◽  
pp. 1064-1082
Author(s):  
Claudia I. Henschke ◽  
David F. Yankelevitz ◽  
Artit Jirapatnakul ◽  
Rowena Yip ◽  
Vivian Reccoppa ◽  
...  
Keyword(s):  
Health Care ◽  
Healthcare System ◽  
Health Care System ◽  
Low Dose ◽  
Health Care Systems ◽  
Ct Screening ◽  
Low Dose Ct ◽  
Care Systems ◽  
Va Health Care System ◽  
Care System

Wettbewerbsorientierte Reformen im Gesundheitssystem der Schweiz – Vorbild für regulierten Wettbewerb in der deutschen GKV?

2004 ◽  
Vol 5 (1) ◽  
pp. 59-70 ◽  
Author(s):  
Stefan Greß ◽  
Ralf Kocher ◽  
Jürgen Wasem
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Behavioral Changes ◽  
Swiss Health ◽  
Care Systems ◽  
Swiss Experience ◽  
Regulated Competition ◽  
Care System ◽  
The Way

Abstract Recent reforms of the Swiss health care system to introduce regulated competition have raised expectations about the possible combination of more efficient services, while at same time maintaining or even increasing the level of solidarity in health care systems. In this article we examine expected behavioral changes of the market actors, the way incentives for market actors have been changed and analyze the way market actors in fact changed their behavior. We conclude that so far only some of the targets of the reforms have been met. For a reasonable assessment of the Swiss experience in regulating competition in health care it is paramount to distinguish expected effects from actual effects.

scholarly journals THE WAY THE HEALTH CARE SYSTEM IN UKRAINE LOOKS LIKE: INTERNATIONAL PRACTICES WITHIN NATIONAL REALITIES

2019 ◽  
Vol 72 (4) ◽  
pp. 685-691
Author(s):  
Borys O. Lohvynenko ◽  
Roman V. Myroniuk ◽  
Olexander P. Svitlychnyy ◽  
Aleksey Y. Prokopenko ◽  
Lidija I. Kalenichenko
Keyword(s):  
Health Care ◽  
Health Care System ◽  
National Health ◽  
Health Care Systems ◽  
World Health ◽  
National Health Care ◽  
National Health Care System ◽  
Care Systems ◽  
Health Organization ◽  
Care System

Introduction: Nowadays there is the transformation of the national health care system in Ukraine, the ultimate goal of which is to create a modern, competitive model of medical care of citizens on the basis of forming packages of free medical services. However, the model adopted by Ukraine is in contradiction with national legislation in part of free medical aid guaranteed by the Art. 49 of the Constitution of Ukraine, and fragmentary considers positive international practices. The aim of the paper is to determine the mistakes of the reform of the Ukrainian health care system and to reveal the positive international practices of the organization of health care systems that can be implemented in Ukraine. Materials and methods: National and international legislation, official web resources of the executive authorities of Ukraine, statistics of the World Health Organization, materials of journalistic and scientific periodicals are the materials for the research of the health care system in Ukraine in comparison with international practices. Research methods are cross-sectoral, complex statistical, comparative, generalization, analysis and synthesis. In order to obtain the results, the authors have conducted a critical analysis of the current norms of the national Ukrainian legislation in the health care sector. Review: The authors of the article have studied the main disadvantages of the national health care system in accordance with the concept of reforming the medical sector. Positive international practices that can be implemented into Ukrainian system for the real improvement of medical human rights in Ukraine have been revealed. Conclusions: It has been proved that the ongoing reform of the health care system in Ukraine needs to be reviewed and optimized. It has been offered to consolidate a perspective model of the Ukrainian health care system, its principles and guarantees of immunity at the legislative level.

scholarly journals Governance of health care systems in an ageing world – the case of Australia

2015 ◽  
Vol 13 (1) ◽  
pp. 729-735 ◽  
Author(s):  
Ewa Banasik
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Well Being ◽  
World Health ◽  
The Political ◽  
Central Component ◽  
Australian Health ◽  
Care Systems ◽  
Care System

The main argument of this paper is that because the burden of diseases increases with age, a greater numbers of older individuals will increase the demand for health care, and whether this demand will be met very much depends on how health care systems are governed. This task is particularly complex in jurisdictions with multi-layer governing systems such as the Australian health care system. Governance, described in terms of stewardship of the well-being of the population and as a central component for building effective health care systems, is increasingly considered to be very important for a well performing health care system (World Health Organization, 2000, 2007). Governance is, however, the least studied function in a health care system (Alliance 2009). Furthermore, the limited governance frameworks and assessments that have been developed thus far fail to include the political context in which health care systems operate (Baez-Camargo and Jacobs, 2011). This paper intends to fill this knowledge gap by exploring the political dynamics of the Australian health care system’s governance and its accountability. Furthering the discourse on governance is especially important in times when health care systems are confronted with the challenges of ageing populations

scholarly journals Human-geographical peculiarities of the healthcare system of Ukraine in the conditions of modern challenges

2021 ◽  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Swot Analysis ◽  
Health Care Systems ◽  
Practical Significance ◽  
Medical Systems ◽  
Advantages And Disadvantages ◽  
Care Systems ◽  
Key Features ◽  
Care System

Relevance. The paper examines the issues of the health care system development of Ukraine in the context of modern challenges. Today, there are many global environmental, socio-demographic, and economic problems threatening the existence of human civilization. One of the problems was the spread of coronavirus infection COVID-19, which demonstrated unpreparedness of Ukraine and post-socialist countries' health care systems. These countries are undergoing health care transformations, but they do not meet modern world norms and standards. The purpose of the article is to establish the key features of the health care system of Ukraine during its transformation given the positive experience of medical systems in the world, from the positions of human geography to identify current challenges and to assess the ability to respond to social demand and the threat of the global crisis in the form of new diseases, the spread of epidemics threatening to human health, quality and life expectancy. Methods. This research is conducted on the basis of human-geographical approach with use of the set of methods and tools to analyze the health care system, which is extremely important for obtaining verified and scientifically sound results. In particular, the authors used methods of induction and deduction, comparison, formalization, analogy, analysis, systematization, including ranking and grouping, historical, graphical, mathematical and statistical, SWOT-analysis methods. Results. Scientific novelty and practical significance. The features, advantages and disadvantages of existing models of health care systems in different countries were identified. In particular, models of medical systems were considered: a model of the single-payer, model of obligatory insurance, and hybrid system. The peculiarities of the formation of the health care system of Ukraine were determined, the key features and principles of the M.O. Semashko’s system were identified, its positive and negative features preserved to this day were outlined. The distribution of European and post-socialist countries was analyzed according to the indicators of state budget expenditures on health care and GDP, number of doctors, hospital beds per capita. The transformational processes in the health care system of Ukraine, the peculiarities of the medical reform in Ukraine were revealed, the peculiarities of the development of the medical system in the conditions of the pandemic were characterized. The SWOT analysis identified the strengths and weaknesses of the Ukraine’s health care system in terms of reform and transformation, its opportunities and threats in the light of current challenges.

scholarly journals Enhancement of Reputation Aggregation based Dynamic Trust Protocols for Edge Computing based E-Health Care System

2021 ◽  
Author(s):  
Mary Subaja Christo ◽  
Bommi R M ◽  
Anandaraj S P ◽  
Udhaya Sankar S M ◽  
Anbarasu V ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Trust Model ◽  
Edge Computing ◽  
Trust Value ◽  
Dynamic Trust ◽  
Care Systems ◽  
E Learning ◽  
Care System

Abstract In recent years, E-services such as e-healthcare, e-learning, e-ticketing, depend on computer networks where the attackers have started introducing new types of attacks. Therefore, it is necessary to enhance security for communication which is needed for the transfer of confidential information relating to patients through the network. In our research we have developed a reputation aggregation based dynamic trust model for edge computing based E-health care systems. In this model, the edge node evaluates the trust value of a user and allows the user to access the E-health care system only when the trust value is satisfied. In order to do this, initially the user information is collected with the help of user agents and then this information is processed and the relevant data alone is sent to the edge nodes for evaluating the trust. Finally, the trusted users can be identified through edge nodes and they are only given the permission to access the e-health care system. Attacks generated in the simulations are detected using the prevailing algorithms and also the suggested techniques. The simulation results of this work prove the ability of the proposed techniques which are used to detect the attacks accurately and to prevent them effectively.

scholarly journals Źródła finansowania ochrony zdrowia w Polsce i we Włoszech

2019 ◽  
Vol 115 ◽  
pp. 81-95
Author(s):  
Paweł Lenio
Keyword(s):  
Health Care ◽  
Local Government ◽  
Health Care System ◽  
Health Care Systems ◽  
Specific Model ◽  
Legal Structure ◽  
Care Systems ◽  
Financing Health Care ◽  
The Difference ◽  
Care System

SOURCES OF FINANCING OF THE HEALTH CARE SYSTEM IN POLAND AND IN ITALYThe study found that the majority of similarities and differences in the legal structure of Polish and Italian sources of financing of health care are the result of the adoption of a specific model of health care, and therefore there are fundamental differences between the catalogues of sources of financing health care in Poland and Italy. The basis for the difference between the Italian and Polish catalogues of sources of financing health care is the obligation of patients to contribute to the costs of the health care system in Italy by paying fees in return for receiving a certain type of service. In the reforms of the Polish and Italian health care systems one can see signs of transferring more and more responsibility to local government units. However, Italian and Polish local government units have no influence on the principles of functioning of the system and the shape of basic sources of financing health care.

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