Contrasting Event-Specific Admissions with Total Admissions: Implications for Validity .


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Comparing "Event-Specific Admissions" to "Total Admissions": Implications for Validity. Ariel Linden, DrPH, MS President, Linden Consulting Group www.LindenConsulting.org. Population NND Analysis (1). Assumptions Population Size = 100,000 Discharge Rate = 1045 per 100,000 ALOS = 4.8 days
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Slide 1

Looking at "Event-Specific Admissions" to "Total Admissions": Implications for Validity Ariel Linden, DrPH, MS President, Linden Consulting Group www.LindenConsulting.org

Slide 2

Population NND Analysis (1) Assumptions Population Size = 100,000 Discharge Rate = 1045 for every 100,000 ALOS = 4.8 days Hospital Day Rate = $1000 Cost per concede = $4800 Vendor expenses = $0.90 X 100,000 X 12 = $1,080,000

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Population NND Analysis (2) To make back the initial investment : Vendor charges $1,080,000 Cost/Admit $4800 225 affirmations (from these 4 maladies) must be decreased keeping in mind the end goal to make back the initial investment on charges. Percent diminish from gauge = 225 ÷ 1045 = 21.5% = 225 =

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Population NND Analysis (3) Table 1. Accept $0.90 PMPM program expenses Cost/day = $1000 Cost/day = $2000 ROI NND % Decrease NND % Decrease 1.0 225 21.5 113 10.8 1.5 338 32.3 170 16.2 2.0 450 43.0 226 21.6 2.5 563 53.8 283 27.0 3.0 675 64.5 339 32.4

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Criticism of Disease-Specific Measures Reviewing malady just hospitalization information ignores changes in intense use for comorbidities of the essential condition therefore, reserve funds are thought little of

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Disease Specific versus Non Disease? We would anticipate that the mediation will diminish usage in the focused on infection (essential result) and at exactly that point affect other non-particular results. "Restorative Specificity": it ought not be expected that an intercession focusing on one ailment will affect another.

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Intervention Specificity Example: Diabetes administration and coronary illness Clinical trials have not yet demonstrated that forceful administration of HbA1c in diabetics prompts measurable decreases in CV occasions. Serious BP and lipid administration is more financially savvy than focusing on HbA1c as a method for decreasing CAD.

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NND in a Diabetic Population (1) Claims information from a medium-sized wellbeing arrangement were recovered for the period somewhere around 2001 and 2004 Diabetics in a wellbeing arrangement were distinguished reflectively utilizing HEDIS 2006 criteria Overall predominance was 5%

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NND in a Diabetic Population (2) Table 3. Qualities of the diabetic associate under study Commercial (77.8%) Medicare (14.2%) Medicaid (8.0%) Age 48.9 71.3 46.5 Female (%) 59.8 66.0 60.3 Enrollment (months) 25.0 20.0 27.0

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Research Findings Using a malady particular companion evokes considerably more stringent execution prerequisites than at the populace level for DM to equal the initial investment Expanding the judgments to incorporate almost everything identified with the ailment does not moderate the "weight of verification" expected to exhibit ROI

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References Linden A. What will it take for illness administration to show an arrival on venture? New points of view on an old topic. Am J Manage Care 2006;12(4):217-222. Linden A, Biuso TJ. Looking for budgetary investment funds from ailment administration: applying the number expected to diminish (NND) examination to a diabetic populace. Dis Manage Health Outc 2006;14(4):197-202.

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Q & An Ariel Linden, DrPH, MS Email: alinden@Lindenconsulting.org

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