Uncovering Longitudinal Healthcare Utilization from Patient-Level Medical Claims Data

TL;DR

This paper introduces a model-based methodology for analyzing patient-level longitudinal healthcare utilization data, enabling visualization and comparison of behaviors within large healthcare systems like Medicaid.

Contribution

It presents a general framework for studying longitudinal healthcare utilization, with a specific application to Medicaid claims data for children with asthma across two states.

Findings

Identified heterogeneity in healthcare utilization behaviors.

Visualized longitudinal utilization patterns using stochastic graphical networks.

Compared healthcare utilization between Georgia and North Carolina.

Abstract

The objective of this study is to introduce methodology for studying longitudinal claims data observed at the patient level, with inference on the heterogeneity of healthcare utilization behaviors within large healthcare systems such as Medicaid. The proposed approach is model-based, allowing for visualization of longitudinal utilization behaviors using simple stochastic graphical networks. The approach is general, providing a framework for the study of other chronic conditions wherever longitudinal healthcare utilization data are available. Our methods are inspired by and applied to patient-level Medicaid claims for asthma-diagnosed children diagnosed observed over a period of five years, with a comparison of two neighboring states, Georgia and North Carolina.