IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i18p3472-d268327.html
   My bibliography  Save this article

Exploration of Medical Trajectories of Stroke Patients Based on Group-Based Trajectory Modeling

Author

Listed:
  • Ting-Ying Chien

    (Department of Computer Science and Engineering, Yuan Ze University, Taoyuan City 320, Taiwan
    Graduate Program in Biomedical Informatics, Yuan Ze University, Taoyuan City 320, Taiwan
    Innovation Center for Big Data and Digital Convergence, Yuan Ze University, Taoyuan City 320, Taiwan)

  • Mei-Lien Lee

    (Department of Computer Science and Engineering, Yuan Ze University, Taoyuan City 320, Taiwan
    These authors contributed equally to this work.)

  • Wan-Ling Wu

    (Department of Computer Science and Engineering, Yuan Ze University, Taoyuan City 320, Taiwan
    These authors contributed equally to this work.)

  • Hsien-Wei Ting

    (Graduate Program in Biomedical Informatics, Yuan Ze University, Taoyuan City 320, Taiwan
    Department of Neurosurgery, Taipei Hospital, Ministry of Health and Welfare, New Taipei City 242, Taiwan)

Abstract

A high mortality rate is an issue with acute cerebrovascular disease (ACVD), as it often leads to a high medical expenditure, and in particular to high costs of treatment for emergency medical conditions and critical care. In this study, we used group-based trajectory modeling (GBTM) to study the characteristics of various groups of patients hospitalized with ACVD. In this research, the patient data were derived from the 1 million sampled cases in the National Health Insurance Research Database (NHIRD) in Taiwan. Cases who had been admitted to hospitals fewer than four times or more than eight times were excluded. Characteristics of the ACVD patients were collected, including age, mortality rate, medical expenditure, and length of hospital stay for each admission. We then performed GBTM to examine hospitalization patterns in patients who had been hospitalized more than four times and fewer than or equal to eight times. The patients were divided into three groups according to medical expenditure: high, medium, and low groups, split at the 33rd and 66th percentiles. After exclusion of unqualified patients, a total of 27,264 cases (male/female = 15,972/11,392) were included. Analysis of the characteristics of the ACVD patients showed that there were significant differences between the two gender groups in terms of age, mortality rate, medical expenditure, and total length of hospital stay. In addition, the data were compared between two admissions, which included interval, outpatient department (OPD) visit after discharge, OPD visit after hospital discharge, and OPD cost. Finally, the differences in medical expenditure between genders and between patients with different types of stroke—ischemic stroke, spontaneous intracerebral hemorrhage (sICH), and subarachnoid hemorrhage (SAH)—were examined using GBTM. Overall, this study employed GBTM to examine the trends in medical expenditure for different groups of stroke patients at different admissions, and some important results were obtained. Our results demonstrated that the time interval between subsequent hospitalizations decreased in the ACVD patients, and there were significant differences between genders and between patients with different types of stroke. It is often difficult to decide when the time has been reached at which further treatment will not improve the condition of ACVD patients, and the findings of our study may be used as a reference for assessing outcomes and quality of care for stroke patients. Because of the characteristics of NHIRD, this study had some limitations; for example, the number of cases for some diseases was not sufficient for effective statistical analysis.

Suggested Citation

  • Ting-Ying Chien & Mei-Lien Lee & Wan-Ling Wu & Hsien-Wei Ting, 2019. "Exploration of Medical Trajectories of Stroke Patients Based on Group-Based Trajectory Modeling," IJERPH, MDPI, vol. 16(18), pages 1-11, September.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:18:p:3472-:d:268327
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/18/3472/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/16/18/3472/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ting-Ying Chien & Hsien-Wei Ting & Chien-Lung Chan & Nan-Ping Yang & Ren-Hao Pan & K. Robert Lai & Su-In Hung, 2017. "Does the Short-Term Effect of Air Pollution Influence the Incidence of Spontaneous Intracerebral Hemorrhage in Different Patient Groups? Big Data Analysis in Taiwan," IJERPH, MDPI, vol. 14(12), pages 1-10, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Zesheng Chen & Bin Wang & Yanlin Hu & Lan Dai & Yangming Liu & Jing Wang & Xueqin Cao & Yiming Wu & Ting Zhou & Xiuqing Cui & Tingming Shi, 2022. "Short-Term Effects of Low-Level Ambient Air NO 2 on the Risk of Incident Stroke in Enshi City, China," IJERPH, MDPI, vol. 19(11), pages 1-13, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.

      Corrections

      All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:18:p:3472-:d:268327. See general information about how to correct material in RePEc.

      If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

      If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

      If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

      For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

      Please note that corrections may take a couple of weeks to filter through the various RePEc services.

      IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.