Measuring quality in diabetes care: an expert-based statistical approach
Author(s)Bertsimas, Dimitris J.; Czerwinski, David; Kane, Michael A.
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We present a methodology for using health insurance claims data to monitor quality of care. The method uses a statistical model trained on the quality ratings of a medical expert. In a pilot study, the expert rated the quality of care received over the course of two years by 101 diabetes patients. A logistic regression model accurately identified the quality of care for 86% of the patients. Because the model uses data derived from patients’ health insurance claims it can be used to monitor the care being received by a large patient population. One important use of the model is to identify potential candidates for case management, especially patients with complicated medical histories.
DepartmentMIT Medical; Sloan School of Management
Bertsimas, Dimitris, David Czerwinski, and Michael Kane. 2013. Measuring Quality in Diabetes Care: An Expert-based Statistical Approach. SpringerPlus 2(1): 226.
Author's final manuscript