KMID : 1100520200260020129
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Healthcare Informatics Research 2020 Volume.26 No. 2 p.129 ~ p.145
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Factors Associated with 5-Year Costs of Care among a Cohort of Alcohol Use Disorder Patients: A Bayesian Network Model
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Rautiainen Elina
Ryynanen Olli-Pekka Laatikainen Tiina Kekolahti Pekka
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Abstract
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Objectives: To examine the direct effects of risk factors associated with the 5-year costs of care in persons with alcohol use disorder (AUD) and to examine whether remission decreases the costs of care.
Methods: Based on Electronic Health Record data collected in the North Karelia region in Finland from 2012 to 2016, we built a non-causal augmented naive Bayesian (ANB) network model to examine the directional relationship between 16 risk factors and the costs of care for a random cohort of 363 AUD patients. Jouffe¡¯s proprietary likelihood matching algorithm and van der Weele¡¯s disjunctive confounder criteria (DCC) were used to calculate the direct effects of the variables, and sensitivity analysis with tornado diagrams and analysis maximizing/minimizing the total cost of care were conducted.
Results: The highest direct effect on the total cost of care was observed for a number of chronic conditions, indicating on average more than a ¢æ26,000 increase in the 5-year mean cost for individuals with multiple ICD-10 diagnoses compared to individuals with less than two chronic conditions. Remission had a decreasing effect on the total cost accumulation during the 5-year follow-up period; the percentage of the lowest cost quartile (42.9% vs. 23.9%) increased among remitters, and that of the highest cost quartile (10.71% vs. 26.27%) decreased compared with current drinkers.
Conclusions: The ANB model with application of DCC identified that remission has a favorable causal effect on the total cost accumulation. A high number of chronic conditions was the main contributor to excess cost of care, indicating that comorbidity is an essential mediator of cost accumulation in AUD patients.
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KEYWORD
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Bayes Theorem, Causality, Alcohol-Related Disorders, Health Care Costs, Costs and Cost Analysis
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