Schizophrenia is a chronic and debilitating disease that affects approximately one percent of the US population and exerts a disproportionately high financial burden on the society. The objective of this study was to estimate the direct and indirect costs of schizophrenia among community-dwelling US residents and identify patient characteristics associated with high schizophrenia-related direct costs. Patients with a diagnosis of schizophrenia (ICD-9 code 295) or other non-organic psychoses (ICD-9 code 298) between January 1, 2005 and December 31, 2008 were identified from the Medical Expenditure Panel Survey (MEPS). To estimate direct costs, the following cost categories were identified: inpatient hospitalizations, outpatient visits, emergency department visits, office-based physician visits, home healthcare visits, and prescription medications. The following cost categories were identified to estimate indirect costs: caregivers’ costs and cost of lost productivity due to missed work days, reduced employment, and suicide. Logistic regression was used to compare patients belonging to the high-cost group and to the low-cost group. All analyses were carried out using SAS version 9.2 (SAS Institute Inc., Cary, North Carolina). The weighted average number of patients with schizophrenia identified for each year was 757,893. The annual direct and indirect costs were estimated at $3.96 billion and $15.35 billion, respectively. The mean annual direct medical schizophrenia-related cost per patient was $5,586. For each one-year increase in age, patients were 5.7% less likely to be in the high-cost group. Patients with a spouse were 77.7% less likely than patients without a spouse to be in the high-cost group. Healthcare providers and policymakers can use these cost estimates to better understand the economic burden of schizophrenia and identify services and subgroups of patients associated with the highest costs. This would help in the provision of healthcare services to patients with schizophrenia and in the optimization of patient outcomes. / text

Thesis (Ph. D.)--University of Texas at Dallas, 2007. / Includes vita. Includes bibliographical references (leaves 169-177)

Not available / text

Thesis (Ph. D.)--University of Texas at Austin, 2005. / Vita. Includes bibliographical references.

No description available.

In this research, we apply data mining techniques to a nationally-representative expenditure data from the US to predict very high-cost patients in the top 5 cost percentiles, among the general population. Samples are derived from the Medical Expenditure Panel Survey’s Household Component data for 2006-2008 including 98,175 records. After pre-processing, partitioning and balancing the data, the final MEPS dataset with 31,704 records is modeled by Decision Trees (including C5.0 and CHAID), Neural Networks. Multiple predictive models are built and their performances are analyzed using various measures including correctness accuracy, G-mean, and Area under ROC Curve. We conclude that the CHAID tree returns the best G-mean and AUC measures for top performing predictive models ranging from 76% to 85%, and 0.812 to 0.942 units, respectively. Among a primary set of 66 attributes, the best predictors to estimate the top 5% high-cost population include individual’s overall health perception, history of blood cholesterol check, history of physical/sensory/mental limitations, age, and history of colonic prevention measures. It is worthy to note that we do not consider number of visits to care providers as a predictor since it has a high correlation with the expenditure, and does not offer a new insight to the data (i.e. it is a trivial predictor). We predict high-cost patients without knowing how many times the patient was visited by doctors or hospitalized. Consequently, the results from this study can be used by policy makers, health planners, and insurers to plan and improve delivery of health services.

This study explores healthcare coverage disparity using a quantitative analysis on a large dataset from the United States. One of the objectives is to build supervised models including decision tree and neural network to study the efficient factors in healthcare coverage. We also discover groups of people with health coverage problems and inconsistencies by employing unsupervised modeling including K-Means clustering algorithm. Our modeling is based on the dataset retrieved from Medical Expenditure Panel Survey with 98,175 records in the original dataset. After pre-processing the data, including binning, cleaning, dealing with missing values, and balancing, it contains 26,932 records and 23 variables. We build 50 classification models in IBM SPSS Modeler employing decision tree and neural networks. The accuracy of the models varies between 76% and 81%. The models can predict the healthcare coverage for a new sample based on its significant attributes. We demonstrate that the decision tree models provide higher accuracy that the models based on neural networks. Also, having extensively analyzed the results, we discover the most efficient factors in healthcare coverage to be: access to care, age, poverty level of family, and race/ethnicity.

In this research, we apply data mining techniques to a nationally-representative expenditure data from the US to predict very high-cost patients in the top 5 cost percentiles, among the general population. Samples are derived from the Medical Expenditure Panel Survey’s Household Component data for 2006-2008 including 98,175 records. After pre-processing, partitioning and balancing the data, the final MEPS dataset with 31,704 records is modeled by Decision Trees (including C5.0 and CHAID), Neural Networks. Multiple predictive models are built and their performances are analyzed using various measures including correctness accuracy, G-mean, and Area under ROC Curve. We conclude that the CHAID tree returns the best G-mean and AUC measures for top performing predictive models ranging from 76% to 85%, and 0.812 to 0.942 units, respectively. Among a primary set of 66 attributes, the best predictors to estimate the top 5% high-cost population include individual’s overall health perception, history of blood cholesterol check, history of physical/sensory/mental limitations, age, and history of colonic prevention measures. It is worthy to note that we do not consider number of visits to care providers as a predictor since it has a high correlation with the expenditure, and does not offer a new insight to the data (i.e. it is a trivial predictor). We predict high-cost patients without knowing how many times the patient was visited by doctors or hospitalized. Consequently, the results from this study can be used by policy makers, health planners, and insurers to plan and improve delivery of health services.

This study explores healthcare coverage disparity using a quantitative analysis on a large dataset from the United States. One of the objectives is to build supervised models including decision tree and neural network to study the efficient factors in healthcare coverage. We also discover groups of people with health coverage problems and inconsistencies by employing unsupervised modeling including K-Means clustering algorithm. Our modeling is based on the dataset retrieved from Medical Expenditure Panel Survey with 98,175 records in the original dataset. After pre-processing the data, including binning, cleaning, dealing with missing values, and balancing, it contains 26,932 records and 23 variables. We build 50 classification models in IBM SPSS Modeler employing decision tree and neural networks. The accuracy of the models varies between 76% and 81%. The models can predict the healthcare coverage for a new sample based on its significant attributes. We demonstrate that the decision tree models provide higher accuracy that the models based on neural networks. Also, having extensively analyzed the results, we discover the most efficient factors in healthcare coverage to be: access to care, age, poverty level of family, and race/ethnicity.

Back pain is the 6th most costly condition in the United States and is responsible for the most workdays lost. Approximately 33 million American adults suffered from back and neck problems in 2005. The societal cost of chronic back pain (CBP) has not been calculated from a US perspective. Longitudinal data files from Panels 12, 13, and 14 of the Medical Expenditure Panel Survey (MEPS) were used to estimate excess direct (ambulatory visits, inpatient admissions, emergency room visits, and prescription medication) costs and indirect (lost productivity) costs for persons 18 years and older reporting CBP compared to those not reporting back pain. Persons were included in the CBP group if they reported back pain (ICD-9-CM codes 720, 721, 722, 723, 724, 737, 805, 806, 839, 846, 847) in at least 3 consecutive interview rounds. The complex sampling design of MEPS was taken into account to get accurate national estimates. All costs were adjusted to 2011 using Consumer Price Indices. All mean costs were computed using age-stratified regression models, after adjusting for demographic and clinical covariates. Utilization of provider-based complementary and alternative medicine (CAM) among CBP patients was studied, and differences in costs between CAM users and non-users examined. Based on this analysis, the prevalence of CBP in the adult US population was estimated to be 3.76%. Total all-cause costs for CBP patients were estimated to be $187 billion over 2 years (direct costs = $176 billion, indirect cost = $11 billion). Overall estimates of excess costs of CBP over 2 years per person for direct medical costs were $37,129 ($25,273 vs. $48,984; p<0.001). This breaks down to $11,711 ($14,929 vs. $3,219; p<0.001) for ambulatory visits; $3,560 ($6,514 vs. $2,914; p<0.001) for inpatient admissions; $300 ($690 vs. $390; p<0.001) for emergency department visits; and $19,849 ($23,873 vs. $4,024; p<0.001) for prescription medications. Excess indirect costs for CBP patients were $1,668 ($2,329 vs. $661; p<0.001). Thirty-seven percent of CBP patients reported at least one CAM visit. There was no significant difference in overall costs between CAM users and non-users. The high cost of chronic back pain in the US population has potential implications for prioritizing policy, and in attempting to improve care and outcomes for these patients. / text