Predictive Analytics In Healthcare:Medications as a Predictor of Medical Complexity

Abstract

Children with special healthcare needs (CSHCN) require health and related services that exceed those required by most hospitalized children. A small but growing and important subset of the CSHCN group includes medically complex children (MCCs). MCCs typically have comorbidities and disproportionately consume healthcare resources. To enable strategic planning for the needs of MCCs, simple screens to identify potential MCCs rapidly in a hospital setting are needed. We assessed whether the number of medications used and the class of those medications correlated with MCC status. Retrospective analysis of medication data from the inpatients at Seattle Children's Hospital found that the numbers of inpatient and outpatient medications significantly correlated with MCC status. Numerous variables based on counts of medications, use of individual medications, and use of combinations of medications were considered, resulting in a simple model based on three different counts of medications: outpatient and inpatient drug classes and individual inpatient drug names. The combined model was used to rank the patient population for medical complexity. As a result, simple, objective admission screens for predicting the complexity of patients based on the number and type of medications were implemented.

A Real-World Observational Study of Time to Treatment Intensification Among Elderly Patients with Inadequately Controlled Type 2 Diabetes Mellitus

“…A previous study has reported that T2DM patients with OAD polypharmacy were more likely to have poorer glycemic control compared with those patients without polypharmacy. 23 Although not specific to elderly patients with T2DM, predictive models in health care suggest that the number of medications a patient takes is predictive of medical complexity 24 ; therefore, it is possible that health care providers may intensify current treatment(s) in order to reduce adverse outcomes in medically complex patients, for example, those with polypharmacy.…”

“…5 Other studies have found that intensification of treatment decreases with increasing age. 5,6,24 Because of the lack of strong evidence that tight glycemic control is beneficial to older patients with T2DM, health care providers may not intensify treatment regimens in these patients. 25 Previous studies have demonstrated that older patients with T2DM had less treatment intensification compared with patients in other age groups.…”

Processing of Electronic Medical Records for Health Services Research in an Academic Medical Center: Methods and Validation (Preprint)

“…CCI and PPS have both been shown to be a good measure of patient comorbidity and complexity in many studies [28,[31][32][33][34][35].…”

“…While some studies have used the Charlson Comorbidity Index (CCI) [28,[31][32][33] and drug burden [34,35] to estimate patient complexity, validity of these measures as an estimate for patient complexity has rarely been established in Asia. In the absence of income data, SES is typically derived from area-based income level from census data [36,37], insurance status [38] or property value [39,40].…”

Health Care Transformation

“…The final model was translated into new standard operating procedures, adopted enterprise-wide, and resulted in better patient care with reduced costs. 12 The culture of health care may be our biggest challenge, as it can demonstrate powerful "pushback" against transformative change. Academic medical centers should identify and communicate how they can adopt and incorporate new customer-or patient-focused innovations into their clinical programs.…”