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Register a new userA Systematic Approach to Detect Hierarchical Healthcare Cost Drivers and Interpretable Change Patterns
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Huijing Jiang
Publication date
2019
fields
Mathematical Statistics
and research's language is
English
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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.
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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.
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.
Based on the electric vehicle (EV) arrival times and the duration of EV connection to the charging station, we identify charging patterns and derive groups of charging stations with similar charging patterns applying two approaches. The ruled based approach derives the charging patterns by specifying a set of time intervals and a threshold value. In the second approach, we combine the modified l-p norm (as a matrix dissimilarity measure) with hierarchical clustering and apply them to automatically identify charging patterns and groups of charging stations associated with such patterns. A dataset collected in a large network of public charging stations is used to test both approaches. Using both methods, we derived charging patterns. The first, rule-based approach, performed well at deriving predefined patterns and the latter, hierarchical clustering, showed the capability of delivering unexpected charging patterns.
Air pollution is a major risk factor for global health, with both ambient and household air pollution contributing substantial components of the overall global disease burden. One of the key drivers of adverse health effects is fine particulate matter ambient pollution (PM$_{2.5}$) to which an estimated 3 million deaths can be attributed annually. The primary source of information for estimating exposures has been measurements from ground monitoring networks but, although coverage is increasing, there remain regions in which monitoring is limited. Ground monitoring data therefore needs to be supplemented with information from other sources, such as satellite retrievals of aerosol optical depth and chemical transport models. A hierarchical modelling approach for integrating data from multiple sources is proposed allowing spatially-varying relationships between ground measurements and other factors that estimate air quality. Set within a Bayesian framework, the resulting Data Integration Model for Air Quality (DIMAQ) is used to estimate exposures, together with associated measures of uncertainty, on a high resolution grid covering the entire world. Bayesian analysis on this scale can be computationally challenging and here approximate Bayesian inference is performed using Integrated Nested Laplace Approximations. Model selection and assessment is performed by cross-validation with the final model offering substantial increases in predictive accuracy, particularly in regions where there is sparse ground monitoring, when compared to current approaches: root mean square error (RMSE) reduced from 17.1 to 10.7, and population weighted RMSE from 23.1 to 12.1 $mu$gm$^{-3}$. Based on summaries of the posterior distributions for each grid cell, it is estimated that 92% of the worlds population reside in areas exceeding the World Health Organizations Air Quality Guidelines.
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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