背景:保险数据库包含与使用牙科服务有关的有价值的信息。这些数据有助于决策过程,加强风险评估,预测结果。这项研究的目的是确定影响补充被保险人使用牙科服务的模式和因素,采用数据挖掘方法。
方法:2022年使用伊朗的牙科保险数据集进行了二次数据分析。数据挖掘的跨行业标准过程(CRISP-DM)被用作从数据库中提取知识的数据挖掘方法。牙科服务的利用是人们感兴趣的结果,和独立变量是根据保险数据集中的可用信息选择的。牙科服务分为九组:诊断,预防性,牙周,恢复性,牙髓,假肢,植入物,摘除术/外科手术,和正畸手术。独立变量包括年龄,性别,家庭大小,保险史,特许经营,保险限额,和投保人。使用多项逻辑回归模型来研究与牙科护理利用相关的因素。所有分析均使用RapidMiner2020版进行。
结果:分析共包含654,418条记录,相当于118,268名被保险人。主要是,恢复性治疗是最常用的服务,约占所有服务的38%,其次是诊断(18.35%)和牙髓(13.3%)护理。年龄在36至60岁之间的个人在所有牙科服务中的使用率最高。此外,由三到四名成员组成的家庭,有一年保险史的个人,人们签约20%的特许经营权,保险限额高的个人,和投保人较小的被保险人,与同行相比,服务使用率最高。回归模型显示,所有自变量与牙科服务的使用显着相关。然而,不同服务类别的关联模式各不相同。
结论:恢复性治疗成为被保险人中最常用的牙科服务,其次是诊断和牙髓手术。服务利用的模式受被保险人的特征和与其保险相关的属性的影响。
BACKGROUND: Insurance databases contain valuable information related to the use of dental services. This data is instrumental in decision-making processes, enhancing risk assessment, and predicting outcomes. The objective of this study was to identify patterns and factors influencing the utilization of dental services among complementary insured individuals, employing a data mining methodology.
METHODS: A secondary data analysis was conducted using a dental insurance dataset from Iran in 2022. The Cross-Industry Standard Process for Data Mining (CRISP-DM) was employed as a data mining approach for knowledge extraction from the database. The utilization of dental services was the outcome of interest, and independent variables were chosen based on the available information in the insurance dataset. Dental services were categorized into nine groups: diagnostic, preventive, periodontal, restorative, endodontic, prosthetic, implant, extraction/surgical, and orthodontic procedures. The independent variables included age, gender, family size, insurance history, franchise, insurance limit, and policyholder. A multinomial logistic regression model was utilized to investigate the factors associated with dental care utilization. All analyses were conducted using RapidMiner Version 2020.
RESULTS: The analysis encompassed a total of 654,418 records, corresponding to 118,268 insured individuals. Predominantly, restorative treatments were the most utilized services, accounting for approximately 38% of all services, followed by diagnostic (18.35%) and endodontic (13.3%) care. Individuals aged between 36 and 60 years had the highest rate of utilization for any dental services. Additionally, families comprising three to four members, individuals with a one-year insurance history, people contracted with a 20% franchise, individuals with a high insurance limit, and insured individuals with a small policyholder, exhibited the highest rate of service usage compared to their counterparts. The regression model revealed that all independent variables were significantly associated with the use of dental services. However, the patterns of association varied among different service categories.
CONCLUSIONS: Restorative treatments emerged as the most frequently used dental services among insured individuals, followed by diagnostic and endodontic procedures. The pattern of service utilization was influenced by the characteristics of the insured individuals and attributes related to their insurance.