System and method for risk-adjusting indicators of access and utilization based on metrics of distance and time

• US 20040193451A1
• Filed: 01/05/2004
• Published: 09/30/2004
• Est. Priority Date: 02/11/2003
• Status: Active Grant

• Current Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Original Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Inventors: McNair, Douglas S.
• Granted Patent: US 7,617,115 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A method and system suitable for automated adjustment of information represented in the transaction order records from clinical information systems of hospitals, clinics, and emergency rooms, in such a manner as to accurately reflect differences in access to care. Techniques from statistical processing are combined in a method that allows for optimization of the parameters such that statistical hypothesis testing using conventional parametric tests are valid and feasible, on account of close approximation to Gaussian normal distribution. The method and system is designed so as to be robust against wide variations in population density and transportation infrastructure, as reflects remote, rural, suburban, and metropolitan environments. Once optimized, the method and system can achieve reliable performance with regard to longitudinal measurement of health access indicators, which are used in planning and managing health services. The performance of this method and system is superior to predicate methods known to those skilled in the art.

Claims

1. A method in a computing environment for effecting a controlled, recurring assessment of a care episode and service utilization patterns on a county or local level, the method comprising the steps of:

accessing transmissions data received from a plurality of corresponding institutions;

totalizing said proband counts;

transforming the distance values, measured in miles (kilometers) or elapsed time from inception of clinical event to securing appropriate care at a health facility in the catchment area, using a power transform;

transforming the population values for the locale where each care episode originates, measured in persons or persons per square mile (square kilometer);

standardizing, by scaling the raw distance and population values according to the standard deviations and signs of the respective distributions;

weighting the standardized transformed distance and population values and summing to form a provisional index;

standardizing the provisional index, by scaling according to the standard deviation of the provisional index;

iteratively seeking optimal values of power transform exponents λ

₁ and λ

₂, such that the Anderson-Darling measure of deviation from normality is minimized and close to zero;

applying the resultant values transform exponents λ

₁ and λ

₂, to produce an optimized distance index d for each case;

analyzing the distribution of d values to ascertain an optimal binning into N distance categories, dcat; and

risk-adjusting the incidence rates of clinical indicators of access and utilization of health services using the categorized locally transformed normed distance index, dcat, and age and, optionally, other variables, so as to produce an accurate representation of differences in access to health services taking time and distance into account.