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Register a new userA Systematic Approach to Surveillance and Detection of Hierarchical Healthcare Cost Drivers and Utilization Offsets
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Added by
Huijing Jiang
Publication date
2020
fields
Mathematical Statistics
and research's language is
English
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There is strong interest among healthcare payers to identify emerging healthcare cost drivers to support early intervention. However, many challenges arise in analyzing large, high dimensional, and noisy healthcare data. In this paper, we propose a systematic approach that utilizes hierarchical search strategies and enhanced statistical process control (SPC) algorithms to surface high impact cost drivers. Our approach aims to provide interpretable, detailed, and actionable insights of detected change patterns attributing to multiple clinical factors. We also proposed an algorithm to identify comparable treatment offsets at the population level and quantify the cost impact on their utilization changes. To illustrate our approach, we apply it to the IBM Watson Health MarketScan Commercial Database and organized the detected emerging drivers into 5 categories for reporting. We also discuss some findings in this analysis and potential actions in mitigating the impact of the drivers.
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There is strong interest among payers to identify emerging healthcare cost drivers to support early intervention. However, many challenges arise in analyzing large, high dimensional, and noisy healthcare data. In this paper, we propose a systematic approach that utilizes hierarchical and multi-resolution search strategies using enhanced statistical process control (SPC) algorithms to surface high impact cost drivers. Our approach aims to provide interpretable, detailed, and actionable insights of detected change patterns attributing to multiple demographic and clinical factors. We also proposed an algorithm to identify comparable treatment offsets at the population level and quantify the cost impact on their utilization changes.
Methods for addressing missing data have become much more accessible to applied researchers. However, little guidance exists to help researchers systematically identify plausible missing data mechanisms in order to ensure that these methods are appropriately applied. Two considerations motivate the present study. First, psychological research is typically characterized by a large number of potential response variables that may be observed across multiple waves of data collection. This situation makes it more challenging to identify plausible missing data mechanisms than is the case in other fields such as biostatistics where a small number of dependent variables is typically of primary interest and the main predictor of interest is statistically independent of other covariates. Second, there is growing recognition of the importance of systematic approaches to sensitivity analyses for treatment of missing data in psychological science. We develop and apply a systematic approach for reducing a large number of observed patterns and demonstrate how these can be used to explore potential missing data mechanisms within multivariate contexts. A large scale simulation study is used to guide suggestions for which approaches are likely to be most accurate as a function of sample size, number of factors, number of indicators per factor, and proportion of missing data. Three applications of this approach to data examples suggest that the method appears useful in practice.
Complex interconnections between information technology and digital control systems have significantly increased cybersecurity vulnerabilities in smart grids. Cyberattacks involving data integrity can be very disruptive because of their potential to compromise physical control by manipulating measurement data. This is especially true in large and complex electric networks that often rely on traditional intrusion detection systems focused on monitoring network traffic. In this paper, we develop an online detection algorithm to detect and localize covert attacks on smart grids. Using a network system model, we develop a theoretical framework by characterizing a covert attack on a generator bus in the network as sparse features in the state-estimation residuals. We leverage such sparsity via a regularized linear regression method to detect and localize covert attacks based on the regression coefficients. We conduct a comprehensive numerical study on both linear and nonlinear system models to validate our proposed method. The results show that our method outperforms conventional methods in both detection delay and localization accuracy.
In 2017 an estimated 3 billion people used polluting fuels and technologies as their primary cooking solution, with 3.8 million deaths annually attributed to household exposure to the resulting fine particulate matter air pollution. Currently, health burdens are calculated using aggregations of fuel types, e.g. solid fuels, as country-level estimates of the use of specific fuel types, e.g. wood and charcoal, are unavailable. To expand the knowledge base about impacts of household air pollution on health, we develop and implement a Bayesian hierarchical model, based on Generalized Dirichlet Multinomial distributions, that jointly estimates non-linear trends in the use of eight key fuel types, overcoming several data-specific challenges including missing or combined fuel use values. We assess model fit using within-sample predictive analysis and an out-of-sample prediction experiment to evaluate the models forecasting performance.
We propose a hierarchical Bayesian model to estimate the proportional contribution of source populations to a newly founded colony. Samples are derived from the first generation offspring in the colony, but mating may occur preferentially among migrants from the same source population. Genotypes of the newly founded colony and source populations are used to estimate the mixture proportions, and the mixture proportions are related to environmental and demographic factors that might affect the colonizing process. We estimate an assortative mating coefficient, mixture proportions, and regression relationships between environmental factors and the mixture proportions in a single hierarchical model. The first-stage likelihood for genotypes in the newly founded colony is a mixture multinomial distribution reflecting the colonizing process. The environmental and demographic data are incorporated into the model through a hierarchical prior structure. A simulation study is conducted to investigate the performance of the model by using different levels of population divergence and number of genetic markers included in the analysis. We use Markov chain Monte Carlo (MCMC) simulation to conduct inference for the posterior distributions of model parameters. We apply the model to a data set derived from grey seals in the Orkney Islands, Scotland. We compare our model with a similar model previously used to analyze these data. The results from both the simulation and application to real data indicate that our model provides better estimates for the covariate effects.
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