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Subdividing ART-Treated Patients by Modeling of CD4 Cell Count and Analysis of the Medical Burden
  • Min Li,
  • Qunwei Wang,
  • yinzhong shen
Min Li

Corresponding Author:[email protected]

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Qunwei Wang
Nanjing University of Aeronautics and Astronautics
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yinzhong shen
Shanghai Public Health Clinical Center
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Abstract

Objective: AIDS patients need life-long ART, the cost of which has become a heavy medical burden on health systems. In this study, the CD4 cell count variable is modeled to subdivide the ART-treated patients, aiming to reduce the medical burden. Methods: The data of outpatients at the research unit between August 2009 and December 2020 were exported. A recency-frequency (RF) model was established to distinguish and preserve ART-treated patients. The common factor analysis (CFA) was conducted on the three indicators of the baseline/mean/last CD4 cell counts to obtain critical variables, which were then subjected to k-means modeling to subdivide ART-treated patients, and their medical burden was analyzed. Results: A total of 12,106 pieces of ART-treated patients were preserved by RF modeling. The baseline/mean/last CD4 cell counts served as important variables employed for modeling. The patients were divided into 15 types, including two types with poor compliance and poor immune reconstitution, two types with good compliance but poor immune reconstitution, four types with poor compliance but good immune reconstitution and seven types with good compliance and good immune reconstitution. The frequency of visits was 5.25-9.95 visits/person/year, and the percentage of examination fees was 44.24-59.05%, with a medical burden of 4,114-12,677 yuan/person/year, of which 42.62-70.09% was reducible. Poor compliance and poor immune reconstitution lead to excessive visits and frequent examination, which were the leading causes of the heavy medical burden of ART. Conclusion: RF modeling can be used to distinguish ART-treated patients, which can be subdivided by the CD4 cell count.