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Applying data mining in healthcare: an info-structure for delivering 'data-driven' strategic services

Abidi SS

Stud Health Technol Inform, 1999;68:453-6.
PMID: 10724926

Presently, there is a growing demand from the healthcare community to leverage upon and transform the vast quantities of healthcare data into value-added, 'decision-quality' knowledge, vis-à-vis, strategic knowledge services oriented towards healthcare management and planning. To meet this end, we present a Strategic Knowledge Services Info-structure that leverages on existing healthcare knowledge/data bases to derive decision-quality knowledge-knowledge that is extracted from healthcare data through services akin to knowledge discovery in databases and data mining.

Matched MeSH terms: National Health Programs/statistics & numerical data*
Cost-effective analysis of unilateral cochlear implantation under the Taiwan national healthcare insurance

Fang TY, Cheng LJ, Wu DB, Wang PC

Int J Audiol, 2020 01;59(1):39-44.
PMID: 31498005 DOI: 10.1080/14992027.2019.1658907

Objective: The value of cochlear implantation (CI) has not been established in Taiwan. The purpose of this study was to evaluate the cost-effectiveness of paediatric CI within the context of Taiwan's national health insurance (NHI) programme.Design: A Markov model-based cost-utility analysis (CUA) was conducted to evaluate the cost-effectiveness of a unilateral CI (UCI) with a contralateral acoustic hearing aid (UCI-HA) compared with a bilateral HA. We performed one-way sensitivity analyses to identify the cost variables that affected the incremental cost-effectiveness ratio (ICER) the most. Monte Carlo simulation was used to explore the simultaneous effect of all uncertain parameters on cost-effectiveness.Study sample: Not applicable.Results: Compared with bilateral HAs, the ICER for UCI-HA was $6487 per quality-adjusted life year (QALY) gained. The ICERs were consistently below $7000 per QALY gained and were most sensitive to the selling price of the external CI device. When this selling price increased by 10%, the ICER of UCI-HA would increase to $6954 per QALY gained. UCI-HA has a probability greater than 50% of being cost-effective if the cost-effectiveness threshold exceeds approximately $10,000 per QALY.Conclusions: Our analysis suggested that within the context of Taiwan's NHI programme, UCI is highly cost-effective for deaf children.

Matched MeSH terms: National Health Programs/statistics & numerical data*
Fulltext Factors influencing support for National Health Insurance among patients attending specialist clinics in Malaysia

Almualm Y, Alkaff SE, Aljunid S, Alsagoff SS

Glob J Health Sci, 2013 May 14;5(5):1-10.
PMID: 23985101 DOI: 10.5539/gjhs.v5n5p1

This study was carried out to determine the level of support towards the proposed National Health Insurance scheme among Malaysian patients attending specialist clinics at the National University of Malaysia Medical centre and its influencing factors. The cross sectional study was carried out from July-October 2012. 260 patients were selected using multistage sampling method. 71.2% of respondents supported the proposed National Health insurance scheme. 61.4% of respondents are willing to pay up to RM240 per year to join the National Health Insurance and 76.6% of respondents are of the view that enrollment in NHI should be made compulsory. Knowledge had a positive influence on respondent's support towards National Health Insurance. National Health Insurance when implemented in Malaysia can be used to raise funds for health care financing, increase access to health services and achieve the desired health status. More efforts should be taken to promote the scheme and educate the public in order to achieve higher support towards the proposed National Health Insurance. The cost to enroll in NHI as well as services to be included under the scheme should be duly considered.

Matched MeSH terms: National Health Programs/statistics & numerical data*
Ongoing activities to optimize the quality and efficiency of lipid-lowering agents in the Scottish national health service: influence and implications

Leporowski A, Godman B, Kurdi A, MacBride-Stewart S, Ryan M, Hurding S, et al.

Expert Rev Pharmacoecon Outcomes Res, 2018 Dec;18(6):655-666.
PMID: 30014725 DOI: 10.1080/14737167.2018.1501558

BACKGROUND: Prescribing of lipid-lowering agents (LLAs) has increased worldwide including in Scotland with increasing prevalence of coronary heart disease, and higher dose statins have been advocated in recent years. There have also been initiatives to encourage prescribing of generic versus patented statins to save costs without compromising care. There is a need to document these initiatives and outcomes to provide future direction.
METHOD: Assessment of utilization (items dispensed) and expenditure of key LLAs (mainly statins) between 2001 and 2015 in Scotland alongside initiatives.
RESULTS: Multiple interventions over the years have increased international nonproprietary name prescribing (99% for statins) and preferential prescribing of generic versus patented statins, and reduced inappropriate prescribing of ezetimibe. This resulted in a 50% reduction in expenditure of LLAs between 2001 and 2015 despite a 412% increase in utilization, increased prescribing of higher dose statins (71% in 2015) especially atorvastatin following generic availability, and reduced prescribing of ezetimibe (reduced by 72% between 2010 and 2015). As a result, the quality of prescribing has improved.
CONCLUSION: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin prescribing behavior and reduced ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing.

Matched MeSH terms: National Health Programs/statistics & numerical data*