METHODS AND SYSTEMS FOR DETERMINING HEALTH RISK SCORE, RISK OF HOSPITALIZATION AND FORECASTING HEALTHCARE COST
First Claim
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1. A method for determining a patient'"'"'s risk of hospitalization and for forecasting future healthcare cost, comprising:
- receiving a patient'"'"'s clinical data from a plurality of encounters over a predetermined time period;
mapping disease codes in the clinical data to respective chronic diseases;
determining health risk scores for the respective chronic diseases by applying disease models for the respective chronic diseases to the clinical data;
determining average health risk scores of the respective chronic diseases;
determining weighted health risk scores of the respective chronic diseases, wherein the weighted health risk score is determined from the average health risk score of the chronic disease and the average cost of hospitalization due to the chronic disease; and
storing the weighted health risk scores in a memory.
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Abstract
Various disclosed embodiments include methods and systems for determining a plurality of patients'"'"' risk of hospitalization and for forecasting healthcare cost. The method includes receiving a plurality of patients'"'"' clinical data from encounters over a predetermined time period and mapping disease codes in the clinical data of the plurality of patients to respective chronic diseases. The method includes determining, for the plurality of patients, health risk scores for the respective chronic diseases by applying disease models for the respective chronic diseases to the clinical data.
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Citations
28 Claims
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1. A method for determining a patient'"'"'s risk of hospitalization and for forecasting future healthcare cost, comprising:
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receiving a patient'"'"'s clinical data from a plurality of encounters over a predetermined time period; mapping disease codes in the clinical data to respective chronic diseases; determining health risk scores for the respective chronic diseases by applying disease models for the respective chronic diseases to the clinical data; determining average health risk scores of the respective chronic diseases; determining weighted health risk scores of the respective chronic diseases, wherein the weighted health risk score is determined from the average health risk score of the chronic disease and the average cost of hospitalization due to the chronic disease; and storing the weighted health risk scores in a memory. - View Dependent Claims (2, 3, 4, 5, 6)
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7. A method of determining a plurality of patients'"'"' risk of hospitalization and for forecasting healthcare cost, comprising:
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receiving a plurality of patient'"'"'s clinical data from encounters over a predetermined time period; mapping disease codes in the clinical data to respective chronic diseases; determining, for the plurality of patients, health risk scores for the respective chronic diseases by applying disease models for the respective chronic diseases to the clinical data; determining, for the plurality of patients, average health risk scores of the respective chronic diseases; and determining, for the plurality of patients, weighted health risk scores of the respective chronic diseases, wherein the weighted health risk score is determined from the average health risk score of the chronic disease and the average cost of hospitalization due to the chronic disease. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14)
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15. A method of classifying patients into a plurality of risk categories based on risk of hospitalization and healthcare cost, comprising:
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receiving a plurality of patient'"'"'s clinical data from encounters over a predetermined time period; mapping disease codes in the clinical data of the plurality of patients to respective chronic diseases; determining, for the plurality of patients, health risk scores for the respective chronic diseases by applying disease models for the respective chronic diseases to the clinical data; determining, for the plurality of patients, average health risk scores of the respective chronic diseases; determining, for the plurality of patients, weighted health risk scores of the respective chronic diseases, wherein the weighted health risk score is determined from the average health risk score of the chronic disease and the average cost of hospitalization due to the chronic disease; and classifying the patients into the plurality of risk categories based at least on one of the health risk scores, number of hospitalizations and the weighted health risk scores. - View Dependent Claims (16, 17, 18, 19, 20, 21)
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22. A data processing system for determining a plurality of patients'"'"' risk of hospitalization and forecasting healthcare cost, comprising:
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at least one processor; a memory connected to the processor, wherein the data processing system is configured to; receive a plurality of patient'"'"'s clinical data from encounters over a predetermined time period; map disease codes in the clinical data of the plurality of patients to respective chronic diseases; determine, for the plurality of patients, health risk scores for the respective chronic diseases by applying disease models for the respective chronic diseases to the clinical data; determine, for the plurality of patients, average health risk scores of the respective chronic diseases; determine, for the plurality of patients, weighted health risk scores of the respective chronic diseases, wherein the weighted health risk score is determined from the average health risk score of the chronic disease and the average cost of hospitalization due to the chronic disease; and store the health risk scores in the memory. - View Dependent Claims (23, 24, 25, 26, 27)
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28. A non-transitory computer-readable medium encoded with computer-executable instructions for determining a plurality of patients'"'"' risk of hospitalization and forecasting healthcare cost, wherein the computer-executable instructions when executed cause at least one data processing system to:
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receive a plurality of patient'"'"'s clinical data from encounters over a predetermined time period; map disease codes in the clinical data of the plurality of patients to respective chronic diseases; determine, for the plurality of patients, health risk scores for the respective chronic diseases by applying disease models for the respective chronic diseases to the clinical data; determine, for the plurality of patients, average health risk scores of the respective chronic diseases; and determine, for the plurality of patients, weighted health risk scores of the respective chronic diseases, wherein the weighted health risk score is determined from the average health risk score of the chronic disease and the average cost of hospitalization due to the chronic disease.
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Specification