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疾病转归背景下心血管疾病治疗成本估算框架

A framework for the estimation of treatment costs of cardiovascular conditions in the presence of disease transition

Annals of Operations Research · 2022
被引 3
ABS 3

中文导读

研究开发了一个基于线性优化的数学框架,用于估算慢性病(如心血管疾病)患者的长期治疗成本,考虑了疾病进展、治疗准确性和决策策略,对政策制定者和医疗服务提供者有用。

Abstract

The current research aims to aid policymakers and healthcare service providers in estimating expected long-term costs of medical treatment, particularly for chronic conditions characterized by disease transition. The study comprised two phases (qualitative and quantitative), in which we developed linear optimization-based mathematical frameworks to ascertain the expected long-term treatment cost per patient considering the integration of various related dimensions such as the progression of the medical condition, the accuracy of medical treatment, treatment decisions at respective severity levels of the medical condition, and randomized/deterministic policies. At the qualitative research stage, we conducted the data collection and validation of various cogent hypotheses acting as inputs to the prescriptive modeling stage. We relied on data collected from 115 different cardio-vascular clinicians to understand the nuances of disease transition and related medical dimensions. The framework developed was implemented in the context of a multi-specialty hospital chain headquartered in the capital city of a state in Eastern India, the results of which have led to some interesting insights. For instance, at the prescriptive modeling stage, though one of our contributions related to the development of a novel medical decision-making framework, we illustrated that the randomized versus deterministic policy seemed more cost-competitive. We also identified that the expected treatment cost was most sensitive to variations in steady-state probability at the "major" as opposed to the "severe" stage of a medical condition, even though the steady-state probability of the "severe" state was less than that of the "major" state.

医疗成本估算慢性病管理运筹学卫生经济学决策分析