Filtering by
- All Subjects: Elderly
- All Subjects: Ratemaking
- Creators: Milovanovic, Jelena
- Creators: Baker, Laurie
Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.
Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).
A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.
The objective of this study is to build a model using R and RStudio that automates ratemaking procedures for Company XYZ’s actuaries in their commercial general liability pricing department. The purpose and importance of this objective is to allow actuaries to work more efficiently and effectively by using this model that outputs the results they otherwise would have had to code and calculate on their own. Instead of spending time working towards these results, the actuaries can analyze the findings, strategize accordingly, and communicate with business partners. The model was built from R code that was later transformed to Shiny, a package within RStudio that allows for the build-up of interactive web applications. The final result is a Shiny app that first takes in multiple datasets from Company XYZ’s data warehouse and displays different views of the data in order for actuaries to make selections on development and trend methods. The app outputs the re-created ratemaking exhibits showing the resulting developed and trended loss and premium as well as the experience-based indicated rate level change based on prior selections. The ratemaking process and Shiny app functionality will be detailed in this report.