Seung Hee Ho

Data mining approach to policy analysis in a health insurance domain

This study examined the characteristics of the knowledge discovery and data mining algorithms to demonstrate how they can be used to predict health outcomes and provide policy information for hypertension management using the Korea Medical Insurance Corporation database. Specifically, this study validated the predictive power of data mining algorithms by comparing the performance of logistic regression and two decision tree algorithms, CHIAD (Chi-squared Automatic Interaction Detection) and C5.0 (a variant of C4.5) using the test set of 4588 beneficiaries and the training set of 13,689 beneficiaries. Contrary to the previous study, the CHIAD algorithm performed better than the logistic regression in predicting hypertension, and C5.0 had the lowest predictive power. In addition, the CHIAD algorithm and the association rule also provided the segment-specific information for the risk factors and target group that may be used in a policy analysis for hypertension management.

Patient satisfaction with telemedicine in home health services for the elderly

In a pilot study of telemedicine in home health services (HHS) for elderly patients, we implemented and evaluated a telemedicine system with a 33-kbs narrow-band approach to determine its effectiveness in providing quality services. Fifty patients were selected for the study. We found that telemedicine was effective in terms of reducing the number of clinic visits and achieving patient satisfaction. The average number of clinic visits per month was significantly decreased from 0.64 to 0.42 (p < 0.05) after the use of telemedicine. 72% of patients were satisfied with telemedicine, but only patient location showed a significant difference for patient satisfaction (p < 0.05). Patients in their homes (82%) were more satisfied than patients in nursing homes (50%). Of four types of services provided, medical consultation (100%) was the most highly satisfactory service with telemedicine, followed by physical therapy (83.3%). Although the satisfaction scores did not indicate a significant difference in the system characteristics, the quality of verbal communication appeared to be a more important factor in influencing patient satisfaction than set-up time or quality of image. A computer-based patient record was also developed to view a patient summary and to document encounters at the patients home. Since the system is a low-cost approach that is easy to interface with a notebook computer, it can support various other HHSs.

Evaluation of a mobile phone-based diet game for weight control.

We developed an interactive mobile-phone based application, SmartDiet, that analyzes daily nutrition intake and patterns of daily exercise. It provides a personalized diet profile and promotes knowledge about nutrition using a diet game. We evaluated the effectiveness of the SmartDiet application in terms of acquiring dietary information, weight control and user satisfaction. A case-control study was conducted over a six-week period, with 19 people in the intervention group and 17 people in the control group. During the study, a total of 235 successful data transmissions were performed from the mobile phones and there was a mean of 12.4 transmissions per participant. The three body composition measures (fat mass, weight and body mass index) decreased significantly after the intervention in the intervention group, but there were no significant changes in the control group. In a questionnaire survey at the end of the study, the majority of the participants responded that the system was useful for obtaining information and managing the diet process. The SmartDiet mobile weight management application appears to contribute to weight loss in obese adults.

Analysis of Healthcare Quality Indicator using Data Mining and Decision Support System

Abstract This study presents an analysis of healthcare quality indicators using data mining for developing quality improvement strategies. Specifically, important factors influencing the inpatient mortality were identified using a decision tree method for data mining based on 8405 patients who were discharged from the study hospital during the period of December 1, 2000 and January 31, 2001. Important factors for the inpatient mortality were length of stay, disease classes, discharge departments, and age groups. The optimum range of target group in inpatient healthcare quality indicators were identified from the gains chart. In addition, a decision support system (DSS) was developed to analyze and monitor trends of quality indicators using Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. In the future, other quality indicators should be analyzed to effectively support a hospital-wide continuous quality improvement (CQI) activity and the DSS should be well integrated with the hospital order communication system (OCS) to support concurrent review.

A Study on User Satisfaction regarding the Clinical Decision Support System (CDSS) for Medication

Objectives Many medication errors can occur when ordering and dispensing medicine in hospitals. The clinical decision support system (CDSS) is widely used in an effort to reduce medication errors. This study focused on the evaluation of user satisfaction with the CDSS for medication at a university hospital. Specifically, this study aimed to identify the factors influencing user satisfaction and to examine user requirements in order to further improve user satisfaction and drug safety. Methods The study was based on survey data from 218 users (103 doctors, 103 nurses, and 15 pharmacists) at a university hospital that uses the CDSS. In order to identify the factors influencing user satisfaction with the CDSS, a multiple linear regression was performed. In order to compare the satisfaction level among the professional groups, an analysis of variance (ANOVA) was performed. Results The reliability of information, decision supporting capability, and departmental support were significant factors in influencing user satisfaction. In addition, nurses were the most satisfied group, followed by pharmacists and doctors according to the ANOVA. Areas for further improvement in enhancing drug safety were real time information searching and decision supporting capabilities to prevent adverse drug events (ADE) in a timely manner. Conclusions We found that the CDSS users were generally satisfied with the system and that it complements the nationwide drug utilization review (DUR) system in reducing ADE. Further CDSS evaluation in other hospitals is needed to improve user satisfaction and drug safety.

Comparison of alternative knowledge model for the diagnosis of asthma

Abstract This paper compared three knowledge models (namely, neural network, case-based reasoning, and discriminant analysis) for the diagnosis of asthma. The data were collected from 294 patients with asthmatic symptoms who visited the Bronchial Asthma Clinics, Internal Medicine Department of Yonsei University Severance Hospital from June 1992 to May 1995. Diagnostic capabilities for the three knowledge models varied. The neural network had the best overall prediction rate (92%) and the best prediction rate for asthma (96%); the discriminant analysis had the best prediction rate for non-asthma (80%); and the CBR had the lowest prediction rates in all categories.

Validation of Performance Indicators for Evaluation of Workplace Health Promotion

Purpose. To validate performance indicators for evaluating workplace health promotion (WHP) programs based on a logic model and to analyze the structural relationships between constructs. Design. The study design is cross-sectional. Setting. Design setting was small manufacturing companies implementing WHP programs provided by the Korea Industrial Health Association. Subjects. Seventeen occupational health experts completed a questionnaire to determine the content validity of indicators. In addition, 58 health care managers completed a questionnaire to determine reliability and construct validation. The response rate was 84.1%. Measures. Based on a logic model, 13 constructs of WHP programs were identified: WHP program input, four activities for workplace environment management, two activities for employee health care management, two outputs, and two short-term outcomes. Analysis. Interrater agreement index was used for testing the content validity of indicators. Confirmatory factor analysis was used to test for the reliabilities, and the convergent and discriminant validities. Structuring equation modeling was also used to analyze the relationships among constructs. Results. A total of 35 performance indicators from 11 constructs showed good reliability and validity. All relationships among WHP input, activities, outputs, and short-term outcomes were significant, except for the relationship between environment outputs and short-term outcome. Conclusion. These findings illustrate that the logic model and structuring equation modeling can be used to develop and validate performance indicators for planning and evaluation of the WHP program.