Healthcare

We estimate the benefit of life-extending medical treatments to life insurance companies. Our main insight is that life insurance companies have a direct benefit from such treatments as they lower the insurer's liabilities by pushing the death benefit further into the future and raise future premium income. We apply this insight to immunotherapy, treatments associated with durable gains in survival rates for a growing number of cancer patients. We estimate that the life insurance sector's aggregate benefit from FDA approved immunotherapies is $9.8 billion a year.

The objective of this study is to gain new insights into the relationship between clinical signs and age at diagnosis utilizing a new, large, online survey of parents of children diagnosed with ASD. Using multiple statistical approaches, we find that clinical signs and symptoms that most strongly predict early diagnosis are not necessarily specific to autism, but rather those that initiate the process that eventually leads to an ASD diagnosis. Given the high correlations between symptoms, only a few symptoms are found to be important in predicting early diagnosis.

Admission control and service rate speedup may be used during periods of congestion to minimize customer waiting in different service settings. In a healthcare setting, this can mean sending patients to alternative care facilities that may take more time and/or provide less ideal treatment. While waiting can be detrimental to patient outcomes, strategies used to control congestion can also be costly. In this work, we examine a multi-server queueing system that considers both admission control and speedup.

Many service systems have servers with different capabilities and customers with varying needs. One common way this occurs is when servers are hierarchical in their skills or in the level of service they can provide. Much of the literature studying such systems relies on an understanding of the relative costs and benefits associated with serving different customer types by the different levels of service. In this work, we focus on estimating these costs and benefits in a complex healthcare setting where the major differentiation among server types is the intensity of service provided.

Objective:

We sought to build on the template-matching methodology by incorporating longitudinal comorbidities and acute physiology to audit hospital quality.

Study Setting:

Patients admitted for sepsis and pneumonia, congestive heart failure, hip fracture, and cancer between January 2010 and November 2011 at 18 Kaiser Permanente Northern California hospitals.

Study Design:

Unplanned transfers of patients from general medical-surgical wards to the Intensive Care Unit (ICU) may occur due to unexpected patient deterioration. Such patients tend to have higher mortality rates and longer lengths of stay than direct admits to the ICU. A new predictive model, the EDIP2, was developed with the intent to identify patients at risk for deterioration, which in some cases could trigger a proactive transfer to the ICU. While it is conceivable that proactive transfers could improve individual patient outcomes, they could also lead to ICU congestion.

Objective:

To understand the impact of adding a medical step-down unit (SDU) on patient outcomes and throughput in a medical intensive care unit (ICU).

Design:

Retrospective cohort study.

Setting:

Two academic tertiary care hospitals within the same health-care system.

Patients:

Adults admitted to the medical ICU at either the control or intervention hospital from October 2013 to March 2014 (preintervention) and October 2014 to March 2015 (postintervention).

I examine the relationship across diseases between the long-run growth in the number of publications about a disease and the change in the mortality rate from the disease. The diseases analyzed are almost all the different forms of cancer. The National Cancer Institute publishes annual data on cancer incidence and cancer mortality, by cancer site.