Applying data envelopment analysis to preventive medicine: a novel method for constructing a personalized risk model of obesity

Is the Efficiency Score an Indicator for Incident Hypertension in the Community Population of Western China?

We aimed to explore the association between the efficiency score and the risk of hypertension. We conducted a prospective cohort study of 2412 adults aged 40 years or above without hypertension in Guizhou, China from 2010 to 2020. The data envelopment analysis input-oriented DEA-CCR model was used to calculate the efficiency scores. The Cox regression model was used to assess the relationship between the efficiency score and incident hypertension. The dose–response relationship was evaluated by restricted cubic spline. Quantile regression was used to analyze the effect of efficiency scores on SBP and DBP. A total of 857 new hypertension cases were identified with a mean follow-up of 6.88 years. The efficiency score was lower in the new hypertension cases than participants without hypertension (0.70 vs. 0.67). After adjusting for possible confounding factors, the HR of hypertension risk was 0.20 (95%CI: 0.09, 0.42) for per 0.1 increase in the efficiency score. The dose–response relationship showed a non-linear relationship between the efficiency score and hypertension risk. Our results showed that the efficiency score was a cost-effective tool to identify those at a high risk of hypertension, and suggested targeted preventive measures should be undertaken.

Efficiency score from data envelopment analysis can predict the future onset of hypertension and dyslipidemia: A cohort study

Primary prevention focuses on ensuring that healthy people remain healthy. As it is practically difficult to provide intervention for an entire healthy population, it is essential to identify and target the at risk of risks population. We aimed to distinguish at risk of risks population using data envelopment analysis (DEA). Efficiency score was calculated from the DEA using a cohort sample and its association with the onset of hypertension and dyslipidemia was analyzed. A stratification analysis was performed according to the number of conventional risk factors in participants. The adjusted odds ratios (aORs) of the incidence of hypertension and dyslipidemia according to a 0.1-point increase in efficiency score were 0.66 (90% confidence interval [CI] 0.55–0.78, p < 0.0001) and 0.84 (90% CI 0.75–0.94, p = 0.01), respectively. In the stratification analysis, aOR of the incidence of hypertension according to a 0.1-point increase in efficiency score was 0.57 (90% CI 0.37–0.89, p = 0.04) in participants with no conventional risk factors. Participants with lower efficiency score were suggested to be at high risk for future onset of hypertension and dyslipidemia. The DEA might enable us to identify the risk of hypertension where conventional methods might fail.

Estimating efficiency of Directive 2011/24/EU cross-border healthcare in member states

Aim: Directive 2011/24/EU on patients' rights in cross-border healthcare facilitates EU citizens' access to and reimbursement for healthcare provided or prescribed in a member state other than the member state of affiliation. Materials & methods: The efficiency of cross-border healthcare policy is evaluated using data envelopment analysis of relevant items in Eurobarometer Survey on Safety and Quality of Care and Patients' Rights in the EU. Results: Our study shows policy inefficiency in 52% of the 25 EU member states included in the analysis. Addressing difficulties patients encounter while seeking reimbursement from their national health service or health insurer and reducing the number of adverse events patients experience when receiving healthcare improves policy efficiency. Conclusion: Our findings confirm that there is country-level variation in cross-border healthcare policy efficiency.