721: The Maternal-Infant Impactability Score™ (MIIS) identifies opportunity to reduce low birth weight through pregnancy care management

Abstract

preterm vs. term birth in the index twin pregnancy. The analysis was further stratified by gestational age at birth, indication for PTB and chorionicity in the index twin pregnancy. Unadjusted odds ratios and confidence intervals were calculated for each of the objectives. RESULTS: A total of 378 women met the study inclusion criteria, of whom 252 (66.7%) had PTB in the index twin pregnancy. The overall rate of PTB in the subsequent singleton pregnancy was 11.6% (44/378) and was significantly higher for women with prior twin PTB compared with women with prior term twin birth (17.5% vs. 6.3%, p¼ 0.003, OR 3.12, 95%-CI 1.42-6.85). The risk of PTB in the subsequent singleton pregnancy was related to the degree of prematurity in the index twin delivery (Figure). The association between previous twin PTB and subsequent singleton PTB was significant only for cases of prior spontaneous twin PTB (OR 3.27, 95%-CI 1.47-7.27) but not for cases of prior indicated twin PTB (OR 2.52, 95%-CI 0.86-7.38). Chorionicity in the index twin delivery did not affect the relationship between prior twin PTB and risk of future singleton PTB. CONCLUSION: History of preterm twin birth is associated with higher odds of subsequent preterm singleton birth, and the risk is related to the severity of prematurity in the index twin PTB.

Bridging the impactibility gap in population health management: a systematic review

“…In these studies, PTS regression analyses were performed using various sociodemographic factors, 26–28 30–32 health status (eg, presence of chronic conditions, prescription data, prior health resource utilisation and various health risk scores) 26–28 30–32 or previous programme engagement metrics. 28 One study found that high costs and high needs did not equate to high impactibility, as only small proportions of people with diseases that would be expected to have high burden had scores indicating high impactibility.…”

“…Five of the identified studies reported the statistical validity of PTS models for projecting cost savings, improved engagement and/or care quality improvements; 26–28 30 32 however, prospective or comparative outcome data on the use of these models in real-world situations were extremely limited in the literature. Two studies reported improved engagement (defined as enrolment of contacted participants) with case management interventions after implementation of a PTS model: Ozminkowski et al 32 reported an 11% increase in programme enrolment in the 9 months after implementation of a PTS model, compared with the 3 months prior.…”

“…Interpreting and comparing the data was difficult due to widespread inconsistency in terminology. Even at the most basic level, ‘high-risk individuals’ was conflated with ‘those most likely to benefit’ in some papers 26 58 despite evidence indicating that these can be highly separated groups. 5 31 42 The quality of the articles included in this review was not graded.…”

“…21 Propensity to succeed PTS modelling is an analytical approach to identify traits associated with improved engagement with or outcomes from particular preventive health intervention(s)outcomes such as cost or care quality. [26][27][28][29][30][31][32] Of the eight studies identified that used this approach, three used PTS modelling in relation to specific case management interventions. [30][31][32] One model was developed explicitly for 'low-risk' participants to assess who would be most likely to benefit from a digital health platform.…”