Hospital Admission Location Prediction via Deep Interpretable Networks for the Year-Round Improvement of Emergency Patient Care

摘要

Objective: This paper presents a deep learning method of predicting where in a hospital emergency patients will be admitted after being triaged in the Emergency Department (ED). Such a prediction will allow for the preparation of bed space in the hospital for timely care and admission of the patient as well as allocation of resource to the relevant departments, including during periods of increased demand arising from seasonal peaks in infections. Methods: The problem is posed as a multi-class classification into seven separate ward types. A novel deep learning training strategy was created that combines learning via curriculum and a multi-armed bandit to exploit this curriculum post-initial training. Results: We successfully predict the initial hospital admission location with area-under-receiver-operating-curve (AUROC) ranging between 0.60 to 0.78 for the individual wards and an overall maximum accuracy of 52% where chance corresponds to 14% for this seven-class setting. Our proposed network was able to interpret which features drove the predictions using a ‘network saliency’ term added to the network loss function. Conclusion: We have proven that prediction of location of admission in hospital for emergency patients is possible using information from triage in ED. We have also shown that there are certain tell-tale tests which indicate what space of the hospital a patient will use. Significance: It is hoped that this predictor will be of value to healthcare institutions by allowing for the planning of resource and bed space ahead of the need for it. This in turn should speed up the provision of care for the patient and allow flow of patients out of the ED thereby improving patient flow and the quality of care for the remaining patients within the ED.