A Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination

Recommendations for prioritizing COVID-19 vaccination have focused on the elderly at higher risk for severe disease. Existing models for identifying higher-risk individuals lack the needed integration of socio-demographic and clinical risk factors. Using multivariate logistic regression and random f...

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Autores principales:	Bettina Experton, Hassan A. Tetteh, Nicole Lurie, Peter Walker, Adrien Elena, Christopher S. Hein, Blake Schwendiman, Justin L. Vincent, Christopher R. Burrow
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 vaccine prioritization COVID-19 booster vaccine severe COVID-19 disease risk for severe COVID-19 infection COVID-19 vaccine booster prioritization Medicare population Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/b58120ecdab64cd9a0786d9ace1323c4
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spelling	oai:doaj.org-article:b58120ecdab64cd9a0786d9ace1323c42021-11-25T16:47:49ZA Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination10.3390/biology101111852079-7737https://doaj.org/article/b58120ecdab64cd9a0786d9ace1323c42021-11-01T00:00:00Zhttps://www.mdpi.com/2079-7737/10/11/1185https://doaj.org/toc/2079-7737Recommendations for prioritizing COVID-19 vaccination have focused on the elderly at higher risk for severe disease. Existing models for identifying higher-risk individuals lack the needed integration of socio-demographic and clinical risk factors. Using multivariate logistic regression and random forest modeling, we developed a predictive model of severe COVID-19 using clinical data from Medicare claims for 16 million Medicare beneficiaries and socio-economic data from the CDC Social Vulnerability Index. Predicted individual probabilities of COVID-19 hospitalization were then calculated for population risk stratification and vaccine prioritization and mapping. The leading COVID-19 hospitalization risk factors were non-white ethnicity, end-stage renal disease, advanced age, prior hospitalization, leukemia, morbid obesity, chronic kidney disease, lung cancer, chronic liver disease, pulmonary fibrosis or pulmonary hypertension, and chemotherapy. However, previously reported risk factors such as chronic obstructive pulmonary disease and diabetes conferred modest hospitalization risk. Among all social vulnerability factors, residence in a low-income zip code was the only risk factor independently predicting hospitalization. This multifactor risk model and its population risk dashboard can be used to optimize COVID-19 vaccine allocation in the higher-risk Medicare population.Bettina ExpertonHassan A. TettehNicole LuriePeter WalkerAdrien ElenaChristopher S. HeinBlake SchwendimanJustin L. VincentChristopher R. BurrowMDPI AGarticleCOVID-19 vaccine prioritizationCOVID-19 booster vaccinesevere COVID-19 diseaserisk for severe COVID-19 infectionCOVID-19 vaccine booster prioritizationMedicare populationBiology (General)QH301-705.5ENBiology, Vol 10, Iss 1185, p 1185 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 vaccine prioritization COVID-19 booster vaccine severe COVID-19 disease risk for severe COVID-19 infection COVID-19 vaccine booster prioritization Medicare population Biology (General) QH301-705.5
spellingShingle	COVID-19 vaccine prioritization COVID-19 booster vaccine severe COVID-19 disease risk for severe COVID-19 infection COVID-19 vaccine booster prioritization Medicare population Biology (General) QH301-705.5 Bettina Experton Hassan A. Tetteh Nicole Lurie Peter Walker Adrien Elena Christopher S. Hein Blake Schwendiman Justin L. Vincent Christopher R. Burrow A Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination
description	Recommendations for prioritizing COVID-19 vaccination have focused on the elderly at higher risk for severe disease. Existing models for identifying higher-risk individuals lack the needed integration of socio-demographic and clinical risk factors. Using multivariate logistic regression and random forest modeling, we developed a predictive model of severe COVID-19 using clinical data from Medicare claims for 16 million Medicare beneficiaries and socio-economic data from the CDC Social Vulnerability Index. Predicted individual probabilities of COVID-19 hospitalization were then calculated for population risk stratification and vaccine prioritization and mapping. The leading COVID-19 hospitalization risk factors were non-white ethnicity, end-stage renal disease, advanced age, prior hospitalization, leukemia, morbid obesity, chronic kidney disease, lung cancer, chronic liver disease, pulmonary fibrosis or pulmonary hypertension, and chemotherapy. However, previously reported risk factors such as chronic obstructive pulmonary disease and diabetes conferred modest hospitalization risk. Among all social vulnerability factors, residence in a low-income zip code was the only risk factor independently predicting hospitalization. This multifactor risk model and its population risk dashboard can be used to optimize COVID-19 vaccine allocation in the higher-risk Medicare population.
format	article
author	Bettina Experton Hassan A. Tetteh Nicole Lurie Peter Walker Adrien Elena Christopher S. Hein Blake Schwendiman Justin L. Vincent Christopher R. Burrow
author_facet	Bettina Experton Hassan A. Tetteh Nicole Lurie Peter Walker Adrien Elena Christopher S. Hein Blake Schwendiman Justin L. Vincent Christopher R. Burrow
author_sort	Bettina Experton
title	A Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination
title_short	A Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination
title_full	A Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination
title_fullStr	A Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination
title_full_unstemmed	A Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination
title_sort	predictive model for severe covid-19 in the medicare population: a tool for prioritizing primary and booster covid-19 vaccination
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b58120ecdab64cd9a0786d9ace1323c4
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A Predictive Model for Severe COVID-19 in the Medicare Population: A Tool for Prioritizing Primary and Booster COVID-19 Vaccination

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