Y Mao

Study on health management decision support system

Abstract To adapt to market informatization, the introduction of health management decision support system can help the management decision of health administration and medical affairs. A database was established according to the requirements of the business layer and data mining technology. Information data which were related to method, model and knowledge in the database were extracted and used for establishing knowledge base, model base and method base; the knowledge base, model base, method base and database were integrated together to form the decision support layer. Finally the decision support layer and presentation layer formed the overall framework of health management decision support system. According to the database characteristics and after comparison of different models, Bayesian discriminant analysis model was determined to be used in the discriminant analysis module, and trend extropolation predictive model was used in the prediction module. The developed system was used to predicting the category of serious diseases, which initially proved the function of health management decision support of the system.

Peculiarity, Environmental and Chronic Diseases: Using Ecological Models as a Framework for Analysising Risk Factors of Chronic Diseases.

Objectives: The French “liste-en-sus” was implemented to support an equal access to innovative and higly-priced medicines. The methodology to define the scope of this list has been updated recently. Listing or delisting is now decided per therapeutic indication and no longer by product. Our aim is to assess the relevance of listed therapeutic indications in accordance with the updated methodology. MethOds: Using the health technology assessment published by the Transparency Committee, we gathered for each medicine included on the liste-en-sus (excluding bloodderived products) until march 1st, 2015 : assessment date, marketing authorization date, medical benefit and improvement in medical benefit (IMB) scores and medicine comparator. We selected therapeutic indications wich fulfilled both criteria : no IMB and the comparator is financed by diagnosis-related groups (DRGs). Using the French medicalized information system program, we identified International classification of diseases (ICD-10) codings groups and we collected expenditures corresponding to these indications in France in 2013. Results: The liste-en-sus includes 214 indications. IMB is available in 87% of cases. 6% of indications have been evaluated before 2005. Another 7% are extensions of indication and they have not been assessed yet as marketing authorization has been granted recently. Among the 32% of indications showing no IMB, the comparator is financed by DRGs in 7% of cases (16 indications or 11 medicines). The 12 ICD-10 codings groups corresponding to these 16 indications show an expenditure of EUR 450.5 million. This amount represents 16% of the total expenditures (EUR 2.8 billion) for all medicines included on the liste-en-sus in 2013. cOnclusiOns: From now on, all indications including extensions of indication have to be evaluated before being registered on the listeen-sus by analyzing the health technology assessment published. 16 therapeutic indications are not matching the criteria defined in the new methodology.