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Title: Modelling for policy in health care : developing innovative approaches to model use of healthcare services and associated expenditure
Author: Cecchini, Michele Serafino
ISNI:       0000 0004 9350 344X
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2017
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Devising suitable approaches to model use of healthcare services and associated expenditure is at the centre of healthcare modelling. Current models focus on predicting total healthcare expenditure at the aggregate level, without accounting for potential interactions between healthcare services. This project aims to develop and test mathematical models designed to: i) model the use of a comprehensive set of healthcare services and total healthcare expenditure as the sum of healthcare service-specific expenditure; and ii) to better understand the potential interactions between different healthcare services. The Medical Expenditure Panel Survey (MEPS) is the primary source of data for the analysis. The models developed as part of this project are tested in a series of case studies. In a first case study, devised models are used to assess the potential savings that could be produced by implementing a set of prevention policies to tackle obesity. Models are then used to project healthcare expenditure up to 2025 by reweighting and projecting MEPS data. A third case study assesses the potential cost associated with substituting informal home healthcare services with formal home healthcare services and gauges the relationship between use of informal home healthcare services and other healthcare services. In a final case study, a generalized propensity score matching approach is used to evaluate the dose-response effect of increasing levels of use of office-based services on inpatient care and other healthcare services in patients with type II diabetes. The resulting models can be used as self-standing tools or may be implemented in more complex attempts as, for example, microsimulation models. Future research should further investigate the dynamics of interaction and substitution between healthcare services to inform policy strategies aimed to curb raising healthcare expenditure.
Supervisor: Smith, Peter ; Mossialos, Elias ; Vlaev, Ivo Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral