Applying sequence clustering techniques to explore practice-based ambulatory care pathways in insurance claims data

Vogt V, Scholz S, Sundmacher L (2018)
EUROPEAN JOURNAL OF PUBLIC HEALTH 28(2): 214-219.

Download
Es wurde kein Volltext hochgeladen. Nur Publikationsnachweis!
Zeitschriftenaufsatz | Veröffentlicht | Englisch
Autor
; ;
Abstract / Bemerkung
Background: Care pathways are a widely used mean to ensure well-coordinated and high quality care by defining the optimal timing and interval of health services for a specific indication. However, evidence on common sequences of services actually followed by patients has rarely been quantified. This study aims to explore whether sequence clustering techniques can be used to empirically identify typical treatment sequences in ambulatory care for heart failure (HF) patients and compare their effectiveness. Methods: Routine data of HF patients were provided by a large statutory sickness fund in Germany from 2009 until 2011. Events were categorized by either (i) the specialty of the physician, (ii) the type of service/procedure provided and (iii) the medication prescribed. Similarities between sequences were measured using the 'longest common subsequence' (LCS). The k-medoids clustering algorithm was applied to identify distinct subgroups of sequences. We used logistic regression to identify the most effective sequences for avoiding hospitalizations. Results: Treatment data of 982 incident HF patients were analyzed to identify typical treatment sequences. The cluster analysis revealed three distinct clusters of specialty sequences, four clusters of procedure sequences and four clusters of prescription sequences. Clusters differed in terms of timing and interval of physician visits, procedures and drug prescriptions as well as comorbidities and HF hospitalization rates. We found no significant association between cluster membership and HF hospitalization. Conclusions: Sequence clustering techniques can be used as an explorative tool to systematically extract, describe compare and analyze treatment sequences and associated characteristics.
Erscheinungsjahr
Zeitschriftentitel
EUROPEAN JOURNAL OF PUBLIC HEALTH
Band
28
Zeitschriftennummer
2
Seite
214-219
ISSN
eISSN
PUB-ID

Zitieren

Vogt V, Scholz S, Sundmacher L. Applying sequence clustering techniques to explore practice-based ambulatory care pathways in insurance claims data. EUROPEAN JOURNAL OF PUBLIC HEALTH. 2018;28(2):214-219.
Vogt, V., Scholz, S., & Sundmacher, L. (2018). Applying sequence clustering techniques to explore practice-based ambulatory care pathways in insurance claims data. EUROPEAN JOURNAL OF PUBLIC HEALTH, 28(2), 214-219. doi:10.1093/eurpub/ckx169
Vogt, V., Scholz, S., and Sundmacher, L. (2018). Applying sequence clustering techniques to explore practice-based ambulatory care pathways in insurance claims data. EUROPEAN JOURNAL OF PUBLIC HEALTH 28, 214-219.
Vogt, V., Scholz, S., & Sundmacher, L., 2018. Applying sequence clustering techniques to explore practice-based ambulatory care pathways in insurance claims data. EUROPEAN JOURNAL OF PUBLIC HEALTH, 28(2), p 214-219.
V. Vogt, S. Scholz, and L. Sundmacher, “Applying sequence clustering techniques to explore practice-based ambulatory care pathways in insurance claims data”, EUROPEAN JOURNAL OF PUBLIC HEALTH, vol. 28, 2018, pp. 214-219.
Vogt, V., Scholz, S., Sundmacher, L.: Applying sequence clustering techniques to explore practice-based ambulatory care pathways in insurance claims data. EUROPEAN JOURNAL OF PUBLIC HEALTH. 28, 214-219 (2018).
Vogt, Verena, Scholz, Stefan, and Sundmacher, Leonie. “Applying sequence clustering techniques to explore practice-based ambulatory care pathways in insurance claims data”. EUROPEAN JOURNAL OF PUBLIC HEALTH 28.2 (2018): 214-219.

28 References

Daten bereitgestellt von Europe PubMed Central.

Changing the chronic care system to meet people's needs.
Anderson G, Knickman JR., Health Aff (Millwood) 20(6), 2001
PMID: 11816653

AUTHOR UNKNOWN, 0

Nolte, 2008
Coordinating care--a perilous journey through the health care system.
Bodenheimer T., N. Engl. J. Med. 358(10), 2008
PMID: 18322289

Legido-Quigley, 2013
The care pathway: concepts and theories: an introduction.
Schrijvers G, van Hoorn A, Huiskes N., Int J Integr Care 12(Spec Ed Integrated Care Pathways), 2012
PMID: 23593066
Reducing clinical variations with clinical pathways: do pathways work?
Panella M, Marchisio S, Di Stanislao F., Int J Qual Health Care 15(6), 2003
PMID: 14660534
Integrated care pathways.
Campbell H, Hotchkiss R, Bradshaw N, Porteous M., BMJ 316(7125), 1998
PMID: 9462322
On mining clinical pathway patterns from medical behaviors.
Huang Z, Lu X, Duan H., Artif Intell Med 56(1), 2012
PMID: 22809825

Lakshmanan, 2013
Which hospitalisations are ambulatory care-sensitive, to what degree, and how could the rates be reduced? Results of a group consensus study in Germany.
Sundmacher L, Fischbach D, Schuettig W, Naumann C, Augustin U, Faisst C., Health Policy 119(11), 2015
PMID: 26428441
[Guidelines for therapy of chronic heart failure].
Hoppe UC, Bohm M, Dietz R, Hanrath P, Kroemer HK, Osterspey A, Schmaltz AA, Erdmann E; Vorstand der Deutschen Gesellschaft fur Kardiologie--Herz- und Kreislaufforschung e.V., Z Kardiol 94(8), 2005
PMID: 16049651
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Ponikowski, Eur Heart J (), 2016

AUTHOR UNKNOWN, 2016

Elzinga, 2007

Gabadinho, 2011

Wickham, 2009
Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland.
Weissman JS, Gatsonis C, Epstein AM., JAMA 268(17), 1992
PMID: 1404795
The role of primary care in preventing ambulatory care sensitive conditions.
Caminal J, Starfield B, Sanchez E, Casanova C, Morales M., Eur J Public Health 14(3), 2004
PMID: 15369028
Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.
Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC, Saunders LD, Beck CA, Feasby TE, Ghali WA., Med Care 43(11), 2005
PMID: 16224307
Specialty-related differences in the epidemiology, clinical profile, management and outcome of patients hospitalized for heart failure; the OSCUR study. Oucome dello Scompenso Cardiaco in relazione all'Utilizzo delle Risore.
Bellotti P, Badano LP, Acquarone N, Griffo R, Lo Pinto G, Maggioni AP, Mattiauda C, Menardo G, Mombelloni P; OSCUR Investigators., Eur. Heart J. 22(7), 2001
PMID: 11259147
Treatment of patients admitted to the hospital with congestive heart failure: specialty-related disparities in practice patterns and outcomes.
Reis SE, Holubkov R, Edmundowicz D, McNamara DM, Zell KA, Detre KM, Feldman AM., J. Am. Coll. Cardiol. 30(3), 1997
PMID: 9283533

Gerste, 2007

Export

Markieren/ Markierung löschen
Markierte Publikationen

Open Data PUB

Web of Science

Dieser Datensatz im Web of Science®

Quellen

PMID: 29040495
PubMed | Europe PMC

Suchen in

Google Scholar