Comparison of the accuracy of classification models to estimate healthcare use and costs associated with COPD exacerbations in Saskatchewan, Canada: A retrospective cohort study
Objective COPD is a high-cost disease and results in frequent contacts with the healthcare system. The study objective was to compare the accuracy of classification models with different covariates for classifying COPD patients into cost groups. Methods Linked health administrative databases from...
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| Format: | Article |
| Language: | English |
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Canadian Society of Respiratory Therapists
2017-08-01
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| Series: | Canadian Journal of Respiratory Therapy |
| Online Access: | https://cjrt.ca/article/81462-comparison-of-the-accuracy-of-classification-models-to-estimate-healthcare-use-and-costs-associated-with-copd-exacerbations-in-saskatchewan-canada-a |
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| author | Kuwornu John Paul Teare Gary F. Quail Jacqueline M. Forget Evelyn Muthukumarana Saman Wang Xiaoyun E. Osman Meric Lix Lisa M. |
| author_facet | Kuwornu John Paul Teare Gary F. Quail Jacqueline M. Forget Evelyn Muthukumarana Saman Wang Xiaoyun E. Osman Meric Lix Lisa M. |
| author_sort | Kuwornu John Paul |
| collection | DOAJ |
| description | Objective
COPD is a high-cost disease and results in frequent contacts with the healthcare system. The study objective was to compare the accuracy of classification models with different covariates for classifying COPD patients into cost groups.
Methods
Linked health administrative databases from Saskatchewan, Canada, were used to identify a cohort of newly diagnosed COPD patients (April 1, 2007 to March 31, 2011) and their episodes of healthcare encounters for disease exacerbations. Total costs of the first and follow-up episodes were computed and patients were categorized as persistently high cost, occasionally high cost, and persistently low cost based on cumulative cost distribution ranking using the 75th percentile cutoff for high-cost status. Classification accuracy was compared for seven multinomial logistic regression models containing socio-demographic characteristics (i.e., base model), and socio-demographic and prior healthcare use characteristics (i.e., comparator models).
Results
Of the 1182 patients identified, 8.5% were classified as persistently high cost, 26.1% as occasionally high cost, and the remainder as persistently low cost. The persistently high-cost and occasionally high-cost patients incurred 10 times (\$12 449 vs \$1263) and seven times (\$9334 vs \$1263) more costs in their first exacerbation episode than persistently low-cost patients, respectively. Classification accuracy was 0.67 for the base model, whereas the comparator model containing socio-demographic and number of prior hospital admissions had the highest accuracy (0.72).
Conclusions
Costs associated with COPD exacerbation episodes are substantial. Adding prior hospitalization to socio-demographic characteristics produced the highest improvements in classification accuracy. Accurate classification models are important for identifying potential healthcare cost management strategies. |
| format | Article |
| id | doaj-art-9d12c2ed0e6f4236bc02b5c923dc669d |
| institution | OA Journals |
| issn | 2368-6820 |
| language | English |
| publishDate | 2017-08-01 |
| publisher | Canadian Society of Respiratory Therapists |
| record_format | Article |
| series | Canadian Journal of Respiratory Therapy |
| spelling | doaj-art-9d12c2ed0e6f4236bc02b5c923dc669d2025-08-20T02:11:21ZengCanadian Society of Respiratory TherapistsCanadian Journal of Respiratory Therapy2368-68202017-08-01533Comparison of the accuracy of classification models to estimate healthcare use and costs associated with COPD exacerbations in Saskatchewan, Canada: A retrospective cohort studyKuwornu John PaulTeare Gary F.Quail Jacqueline M.Forget EvelynMuthukumarana SamanWang Xiaoyun E.Osman MericLix Lisa M.Objective COPD is a high-cost disease and results in frequent contacts with the healthcare system. The study objective was to compare the accuracy of classification models with different covariates for classifying COPD patients into cost groups. Methods Linked health administrative databases from Saskatchewan, Canada, were used to identify a cohort of newly diagnosed COPD patients (April 1, 2007 to March 31, 2011) and their episodes of healthcare encounters for disease exacerbations. Total costs of the first and follow-up episodes were computed and patients were categorized as persistently high cost, occasionally high cost, and persistently low cost based on cumulative cost distribution ranking using the 75th percentile cutoff for high-cost status. Classification accuracy was compared for seven multinomial logistic regression models containing socio-demographic characteristics (i.e., base model), and socio-demographic and prior healthcare use characteristics (i.e., comparator models). Results Of the 1182 patients identified, 8.5% were classified as persistently high cost, 26.1% as occasionally high cost, and the remainder as persistently low cost. The persistently high-cost and occasionally high-cost patients incurred 10 times (\$12 449 vs \$1263) and seven times (\$9334 vs \$1263) more costs in their first exacerbation episode than persistently low-cost patients, respectively. Classification accuracy was 0.67 for the base model, whereas the comparator model containing socio-demographic and number of prior hospital admissions had the highest accuracy (0.72). Conclusions Costs associated with COPD exacerbation episodes are substantial. Adding prior hospitalization to socio-demographic characteristics produced the highest improvements in classification accuracy. Accurate classification models are important for identifying potential healthcare cost management strategies.https://cjrt.ca/article/81462-comparison-of-the-accuracy-of-classification-models-to-estimate-healthcare-use-and-costs-associated-with-copd-exacerbations-in-saskatchewan-canada-a |
| spellingShingle | Kuwornu John Paul Teare Gary F. Quail Jacqueline M. Forget Evelyn Muthukumarana Saman Wang Xiaoyun E. Osman Meric Lix Lisa M. Comparison of the accuracy of classification models to estimate healthcare use and costs associated with COPD exacerbations in Saskatchewan, Canada: A retrospective cohort study Canadian Journal of Respiratory Therapy |
| title | Comparison of the accuracy of classification models to estimate healthcare use and costs associated with COPD exacerbations in Saskatchewan, Canada: A retrospective cohort study |
| title_full | Comparison of the accuracy of classification models to estimate healthcare use and costs associated with COPD exacerbations in Saskatchewan, Canada: A retrospective cohort study |
| title_fullStr | Comparison of the accuracy of classification models to estimate healthcare use and costs associated with COPD exacerbations in Saskatchewan, Canada: A retrospective cohort study |
| title_full_unstemmed | Comparison of the accuracy of classification models to estimate healthcare use and costs associated with COPD exacerbations in Saskatchewan, Canada: A retrospective cohort study |
| title_short | Comparison of the accuracy of classification models to estimate healthcare use and costs associated with COPD exacerbations in Saskatchewan, Canada: A retrospective cohort study |
| title_sort | comparison of the accuracy of classification models to estimate healthcare use and costs associated with copd exacerbations in saskatchewan canada a retrospective cohort study |
| url | https://cjrt.ca/article/81462-comparison-of-the-accuracy-of-classification-models-to-estimate-healthcare-use-and-costs-associated-with-copd-exacerbations-in-saskatchewan-canada-a |
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