Population health management
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An estimated 425 million people globally have diabetes, accounting for 12% of the world's health expenditures, and yet 1 in 2 persons remain undiagnosed and untreated. Applications of artificial intelligence (AI) and cognitive computing offer promise in diabetes care. The purpose of this article is to better understand what AI advances may be relevant today to persons with diabetes (PWDs), their clinicians, family, and caregivers. ⋯ Many of these new AI-powered retinal imaging systems, predictive modeling programs, glucose sensors, insulin pumps, smartphone applications, and other decision-support aids are on the market today with more on the way. AI applications have the potential to transform diabetes care and help millions of PWDs to achieve better blood glucose control, reduce hypoglycemic episodes, and reduce diabetes comorbidities and complications. AI applications offer greater accuracy, efficiency, ease of use, and satisfaction for PWDs, their clinicians, family, and caregivers.
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Emergency medical services (EMS) in the United States are frequently used for nonurgent medical needs. Use of 911 and the emergency department (ED) for primary care-treatable conditions is expensive, inefficient, and undesirable for patients and providers. The objective is to describe the outcomes from community paramedicine (CP) and mobile integrated health care (MIH) interventions related to the Quadruple Aim. ⋯ Most cost savings from reduced utilization will be to insurance companies and patients, but more efficient use of EMS agencies' resources could lead to cost savings that could offset intervention implementation costs. The other 3 aims (health, patient satisfaction, and provider satisfaction) were reported inconsistently in these studies and need to be addressed further. Given the small number of heterogeneous studies reviewed, the potential for CP-MIH interventions to comprehensively address the Quadruple Aim is still unclear, and more research on these programs is needed.
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Between 2002 and 2007, the nonmedical use of prescription pain relievers grew from 11.0 million to 12.5 million people in the United States. Societal costs attributable to prescription opioid abuse were estimated at $55.7 billion in 2007. The purpose of this study was to comprehensively review the recent clinical and economic evaluations of prescription opioid abuse. ⋯ When compared to a matched control group (non-abusers), mean annual excess health care costs for opioid abusers with private insurance ranged from $14,054 to $20,546. Similarly, the mean annual excess health care costs for opioid abusers with Medicaid ranged from $5874 to $15,183. The issue of opioid abuse has significant clinical and economic consequences for patients, health care providers, commercial and government payers, and society as a whole.