从临床数据早期预测门诊敏感入院的潜在可预防事件

P. Desikan, Nisheeth Srivastava, T. Winden, Tammie Lindquist, Heather Britt, J. Srivastava
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引用次数: 4

摘要

门诊护理敏感病症(ACSCs)的特点是,良好的门诊护理可以潜在地避免住院治疗的需要,或者早期干预可以预防并发症或更严重的疾病。目前,在美国卫生系统中有16种确定的ACSCs:糖尿病短期并发症、阑尾穿孔、糖尿病长期并发症、儿童哮喘、慢性阻塞性肺病、儿童胃肠炎、高血压、充血性心力衰竭、低出生体重率、脱水、细菌性肺炎、尿路感染、心绞痛住院、未控制的糖尿病、成人哮喘和糖尿病患者的下肢截肢。这种诊断代码的潜在可预防急性健康事件(ppe)是降低医疗费用同时提高护理质量的直接机会。虽然索赔数据以前被用来预测患者未来的健康结果,但我们在这里报告了一种新的方法,使用数据挖掘技术,将这些数据与患者的电子健康记录(EHR)相补充,以开发一个临床决策支持系统,该系统可以令人满意地预测大量患者的ppe发作。
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Early Prediction of Potentially Preventable Events in Ambulatory Care Sensitive Admissions from Clinical Data
Ambulatory care sensitive conditions (ACSCs) are characterized as health conditions for which good outpatient care can potentially prevent the need for hospitalization, or for which early intervention can prevent complications or more severe disease. Currently, there are 16 identified ACSCs within the US health system: diabetes short-term complication, perforated appendix, diabetes long-term complication, pediatric asthma, chronic obstructive pulmonary disease, pediatric gastroenteritis, hypertension, congestive heart failure, low birth weight rate, dehydration, bacterial pneumonia, urinary tract infection, angina admission without procedure, uncontrolled diabetes, adult asthma, and lower-extremity amputation among patients with diabetes. Potentially preventable acute health events (PPEs) for such diagnosis codes represent a straightforward opportunity for reducing medical costs while concomitantly improving quality of care. While claims data have previously been used to predict future health outcomes of patients, we report here a novel approach, using data mining techniques, towards supplementing such data with patients' electronic health records (EHR) to develop a clinical decision support system that satisfactorily predicts the onset of PPEs in a large population of patients.
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