Temporal Data Analysis of Encounter Patterns to Predict High-Risk Patients in Medicaid
Keywords:
Temporal data analysis, encounter patterns, Medicaid, predictive analyticsAbstract
The study looks at how the analysis of temporal data from patient interactions could help to forecast high-risk Medicaid patients, therefore enabling early intervention & their better allocation of resources. We examine over time patterns in patient visits, hospitalizations & also treatments using ML, statistical models & advanced data analysis techniques. Our approach picks up trends in their healthcare consumption, risk factors suggestive of probable health deterioration & also recurrent patterns. The findings highlight important markers of high-risk people, including frequent ER visits, inadequate preventive care & the progress in chronic illnesses. Medicaid administration & their healthcare professionals may effectively distribute their resources, change treatment plans & reduce avoidable hospitalizations by use of their predictive analytics. The study emphasizes how data-driven decision-making might increase Medicaid operations' efficiency, help to save expenses & raise their patient outcomes by means of their enhanced performance of Medicaid operations. By allowing quick interventions for at-risk populations & changing from reactive to proactive by treatment methods, the integration of predictive models into Medicaid systems can drastically change the provision of their healthcare services.
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References
Raven, Maria C., et al. "Medicaid patients at high risk for frequent hospital admission: real-time identification and remediable risks." Journal of Urban Health 86 (2009): 230-241.
Agarwal, Parul, Thomas K. Bias, and Usha Sambamoorthi. "Longitudinal patterns of emergency department visits: a multistate analysis of Medicaid beneficiaries." Health Services Research 52.6 (2017): 2121-2136.
Moturu, Sai T., William G. Johnson, and Huan Liu. "Predictive risk modelling for forecasting high-cost patients: a real-world application using Medicaid data." International Journal of Biomedical Engineering and Technology 3.1-2 (2010): 114-132.
Lauffenburger, Julie C., Mufaddal Mahesri, and Niteesh K. Choudhry. "Use of data-driven methods to predict long-term patterns of health care spending for Medicare patients." JAMA network open 3.10 (2020): e2020291-e2020291.
Jiang, Wei, et al. "Readmission risk trajectories for patients with heart failure using a dynamic prediction approach: retrospective study." JMIR medical informatics 7.4 (2019): e14756.
Lauffenburger, Julie C., et al. "Longitudinal patterns of spending enhance the ability to predict costly patients: a novel approach to identify patients for cost containment." Medical Care 55.1 (2017): 64-73.
Stein, Bradley D., et al. "Predictors of timely follow-up care among Medicaid-enrolled adults after psychiatric hospitalization." Psychiatric Services 58.12 (2007): 1563-1569.
Hu, Zhongkai, et al. "Real-time web-based assessment of total population risk of future emergency department utilization: statewide prospective active case finding study." Interactive journal of medical research 4.1 (2015): e4022.
Bates, David W., et al. "Big data in health care: using analytics to identify and manage high-risk and high-cost patients." Health affairs 33.7 (2014): 1123-1131.
Cochran, Gerald, et al. "An examination of claims-based predictors of overdose from a large Medicaid program." Medical care 55.3 (2017): 291-298.
Wherry, Laura R., Marguerite E. Burns, and Lindsey Jeanne Leininger. "Using Self‐Reported Health Measures to Predict High‐Need Cases among Medicaid‐Eligible Adults." Health services research 49.S2 (2014): 2147-2172.
Li, Shi, et al. "Association of daily asthma emergency department visits and hospital admissions with ambient air pollutants among the pediatric Medicaid population in Detroit: time-series and time-stratified case-crossover analyses with threshold effects." Environmental research 111.8 (2011): 1137-1147.
Yang, Tianzhong, et al. "Dynamic prediction of hospital admission with medical claim data." BMC medical informatics and decision making 19 (2019): 1-14.
Meisel, Zachary F., et al. "Conversion to persistent or high-risk opioid use after a new prescription from the emergency department: evidence from Washington Medicaid beneficiaries." Annals of emergency medicine 74.5 (2019): 611-621.
Hao, Shiying, et al. "Risk prediction of emergency department revisit 30 days post discharge: a prospective study." PloS one 9.11 (2014): e112944.