Population stratification based on healthcare trajectories: A method for encouraging adaptive learning at meso level

IF 3.6 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES Health Policy Pub Date : 2024-07-29 DOI:10.1016/j.healthpol.2024.105137

Anne-Sophie Lambert , Catherine Legrand , Béatrice Scholtes , Sékou Samadoulougou , Hedwig Deconinck , Lucia Alvarez , Jean Macq

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Abstract

This paper proposes a method to support population management by evaluating population needs using population stratification based on healthcare trajectories.

Reimbursed healthcare consumption data for the first semester of 2017 contained within the inter-mutualist database were analysed to create healthcare trajectories for a subset of the population aged between 60 and 79 (N = 22,832) to identify (1) the nature of health events, (2) key transitions between lines of care, (3) the relative duration of different events, and (4) the hierarchy of events. These factors were classified using a K-mers approach followed by multinomial mixture modelling.

Five population groups were identified using this healthcare trajectory approach: “low users”, “high intensity of nursing care”, “transitional care & nursing care”, “transitional care”, and “long time in hospital”.

This method could be used by loco-regional governing bodies to learn reflectively from the place where care is provided, taking a systems perspective rather than a disease perspective, and avoiding the one-size-fits-all definition. It invites decision makers to make better use of routinely collected data to guide continuous learning and adaptive management of population health needs.

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基于医疗保健轨迹的人口分层：在中观层面鼓励自适应学习的方法。

本文提出了一种基于医疗保健轨迹的人口分层方法，通过评估人口需求来支持人口管理。通过分析互助会间数据库中包含的 2017 年上半年医疗保健消费报销数据，为年龄在 60 岁至 79 岁之间的人口子集（N = 22832）创建医疗保健轨迹，以确定（1）健康事件的性质，（2）医疗线之间的关键转换，（3）不同事件的相对持续时间，以及（4）事件的层次结构。这些因素采用 K-mers 方法进行分类，然后进行多项式混合建模。使用这种医疗轨迹方法确定了五个人群组："低使用者"、"高强度护理"、"过渡性护理和护理"、"过渡性护理 "和 "长期住院"。地方-区域管理机构可以利用这种方法，从提供护理的地方进行反思性学习，从系统角度而不是疾病角度出发，避免一刀切的定义。它能让决策者更好地利用日常收集的数据，指导持续学习和适应性管理人口健康需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Policy 医学-卫生保健

CiteScore

6.40

自引率

6.10%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Health Policy is intended to be a vehicle for the exploration and discussion of health policy and health system issues and is aimed in particular at enhancing communication between health policy and system researchers, legislators, decision-makers and professionals concerned with developing, implementing, and analysing health policy, health systems and health care reforms, primarily in high-income countries outside the U.S.A.