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Predicting all-cause 90-day hospital readmission for dental patients using machine learning methods

机译:使用机器学习方法预测牙科患者的全部导致90天医院住院

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摘要

Abstract Introduction Hospital readmission rates are an indicator of the health care quality provided by hospitals. Applying machine learning (ML) to a hospital readmission database offers the potential to identify patients at the highest risk for readmission. However, few studies applied ML methods to predict hospital readmission. This study sought to assess ML as a tool to develop prediction models for all-cause 90-day hospital readmission for dental patients. Methods Using the 2013 Nationwide Readmissions Database (NRD), the study identified 9260 cases for all-cause 90-day index admission for dental patients. Five ML classification algorithms including decision tree, logistic regression, support vector machine, k-nearest neighbors, and artificial neural network (ANN) were implemented to build predictive models. The model performance was estimated and compared by using area under the receiver operating characteristic curve (AUC), and accuracy, sensitivity, specificity, and precision. Results Hospital readmission within 90 days occurred in 1746 cases (18.9%). Total charges, number of diagnosis, age, number of chronic conditions, length of hospital stays, number of procedures, primary expected payer, and severity of illness emerged as the top eight important features in all-cause 90-day hospital readmission. All models had similar performance with ANN (AUC = 0.743) slightly outperforming the rest. Conclusion This study demonstrates a potential annual saving of over $500 million if all of the 90-day readmission cases could be prevented for 21 states represented in the NRD. Among the methods used, the prediction model built by ANN exhibited the best performance. Further testing using ANN and other methods can help to assess important readmission risk factors and to target interventions to those at the greatest risk.
机译:摘要介绍医院入院率是医院提供的医疗保健品质的指标。将机器学习(ML)应用于医院阅读数据库,提供了识别入住风险最高的患者的可能性。然而,很少有研究应用ML方法预测医院入院。本研究寻求将ML作为一种为牙科患者患者发育全部导致90天医院入院的预测模型的工具。方法采用2013年全国自述数据库(NRD),该研究确定了9260例牙科患者的全部导致90天指数入院案例。实施了五毫升分类算法,包括决策树,逻辑回归,支持向量机,k最近邻居和人工神经网络(ANN)以构建预测模型。通过在接收器操作特性曲线(AUC)下的区域,以及精度,灵敏度,特异性和精度,估计模型性能。结果90天内的医院入院发生在1746例(18.9%)。总收费,诊断数量,年龄,慢性条件数量,医院长度,程序数量,初级预期付款人,以及疾病的严重程度被出现为全导致90天医院入院中的前八个重要功能。所有型号都有类似的性能与ANN(AUC = 0.743)略显优于其余的。结论本研究表明,如果所有90天的入院案件都可以防止在NRD中所代表的21个州,则潜在每年储蓄超过5亿美元。在使用的方法中,由ANN构建的预测模型表现出最佳性能。使用ANN和其他方法的进一步测试可以有助于评估重要的休息风险因素,并以最大风险的方式定位干预措施。

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