Skip to main content
Erschienen in:
Buchtitelbild

2017 | OriginalPaper | Buchkapitel

Predicting 30-Day Emergency Readmission Risk

verfasst von : Arkaitz Artetxe, Andoni Beristain, Manuel Graña, Ariadna Besga

Erschienen in: International Joint Conference SOCO’16-CISIS’16-ICEUTE’16

Verlag: Springer International Publishing

Aktivieren Sie unsere intelligente Suche, um passende Fachinhalte oder Patente zu finden.

search-config
loading …

Abstract

Objective: Predicting Emergency Department (ED) readmissions is of great importance since it helps identifying patients requiring further post-discharge attention as well as reducing healthcare costs. It is becoming standard procedure to evaluate the risk of ED readmission within 30 days after discharge. Methods. Our dataset is stratified into four groups according to the Kaiser Permanente Risk Stratification Model. We deal with imbalanced data using different approaches for resampling. Feature selection is also addressed by a wrapper method which evaluates feature set importance by the performance of various classifiers trained on them. Results. We trained a model for each scenario and subpopulation, namely case management (CM), heart failure (HF), chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM). Using the full dataset we found that the best sensitivity is achieved by SVM using over-sampling methods (40.62 % sensitivity, 78.71 % specificity and 71.94 accuracy). Conclusions. Imbalance correction techniques allow to achieve better sensitivity performance, however the dataset has not enough positive cases, hindering the achievement of better prediction ability. The arbitrary definition of a threshold-based discretization for measurements which are inherently is an important drawback for the exploitation of the data, therefore a regression approach is considered as future work.

Sie haben noch keine Lizenz? Dann Informieren Sie sich jetzt über unsere Produkte:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

  • über 102.000 Bücher
  • über 537 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Maschinenbau + Werkstoffe
  • Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Springer Professional "Technik"

Online-Abonnement

Mit Springer Professional "Technik" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 390 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Maschinenbau + Werkstoffe




 

Jetzt Wissensvorsprung sichern!

Springer Professional "Wirtschaft"

Online-Abonnement

Mit Springer Professional "Wirtschaft" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 340 Zeitschriften

aus folgenden Fachgebieten:

  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Versicherung + Risiko




Jetzt Wissensvorsprung sichern!

Literatur
1.
Zurück zum Zitat World Health Organization: Global health and ageing. World Health Organization, Geneva, Switzerland (2011) World Health Organization: Global health and ageing. World Health Organization, Geneva, Switzerland (2011)
2.
Zurück zum Zitat Besga, A., Ayerdi, B., Alcalde, G., et al.: Risk factors for emergency department short time readmission in stratified population. BioMed Res. Int. 2015, 7 pages (2015). Article ID 685067, doi:10.1155/2015/685067 Besga, A., Ayerdi, B., Alcalde, G., et al.: Risk factors for emergency department short time readmission in stratified population. BioMed Res. Int. 2015, 7 pages (2015). Article ID 685067, doi:10.​1155/​2015/​685067
3.
Zurück zum Zitat Van Walraven, C., et al.: Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. Can. Med. Assoc. J. 182(6), 551–557 (2010)CrossRef Van Walraven, C., et al.: Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. Can. Med. Assoc. J. 182(6), 551–557 (2010)CrossRef
4.
Zurück zum Zitat Van Walraven, C., Wong, J., Forster, A.: LACE+ index: extension of a validated index to predict early death or urgent readmission after hospital discharge using administrative data. Open Med. 6(3), 80–89 (2012) Van Walraven, C., Wong, J., Forster, A.: LACE+ index: extension of a validated index to predict early death or urgent readmission after hospital discharge using administrative data. Open Med. 6(3), 80–89 (2012)
5.
Zurück zum Zitat Yu, S., Farooq, F., van Esbroeck, A., Fung, G., Anand, V., Krishnapuram, B.: Predicting readmission risk with institution-specific prediction models. Artif. Intell. Med. 65(2), 89–96 (2015)CrossRef Yu, S., Farooq, F., van Esbroeck, A., Fung, G., Anand, V., Krishnapuram, B.: Predicting readmission risk with institution-specific prediction models. Artif. Intell. Med. 65(2), 89–96 (2015)CrossRef
6.
Zurück zum Zitat Ho, T.K.: Random decision forests. In: 1995 Proceedings of the Third International Conference on Document Analysis and Recognition, pp. 278–282. IEEE (1995) Ho, T.K.: Random decision forests. In: 1995 Proceedings of the Third International Conference on Document Analysis and Recognition, pp. 278–282. IEEE (1995)
7.
Zurück zum Zitat Cortes, C., Vapnik, V.: Support-vector networks. Mach. Learn. 20(3), 273–297 (1995)CrossRefMATH Cortes, C., Vapnik, V.: Support-vector networks. Mach. Learn. 20(3), 273–297 (1995)CrossRefMATH
8.
Zurück zum Zitat Hall, M., Frank, E., Holmes, G., Pfahringer, B., Reutemann, P., Witten, I.H.: The WEKA data mining software: an update. SIGKDD Explor. 11(1), 10–18 (2009)CrossRef Hall, M., Frank, E., Holmes, G., Pfahringer, B., Reutemann, P., Witten, I.H.: The WEKA data mining software: an update. SIGKDD Explor. 11(1), 10–18 (2009)CrossRef
9.
Zurück zum Zitat Kansagara, D., Englander, H., Salanitro, A., Kagen, D., Theobald, C., Freeman, M., Kripalani, S.: Risk prediction models for hospital readmission: a systematic review. JAMA 306(15), 1688–1698 (2011)CrossRef Kansagara, D., Englander, H., Salanitro, A., Kagen, D., Theobald, C., Freeman, M., Kripalani, S.: Risk prediction models for hospital readmission: a systematic review. JAMA 306(15), 1688–1698 (2011)CrossRef
11.
Zurück zum Zitat Feachem, R.G., Dixon, J., Berwick, D.M., Enthoven, A.C., Sekhri, N.K., White, K.L.: Getting more for their dollar: a comparison of the NHS with California’s Kaiser Permanente. BMJ 324(7330), 135–143 (2002)CrossRef Feachem, R.G., Dixon, J., Berwick, D.M., Enthoven, A.C., Sekhri, N.K., White, K.L.: Getting more for their dollar: a comparison of the NHS with California’s Kaiser Permanente. BMJ 324(7330), 135–143 (2002)CrossRef
12.
Zurück zum Zitat Chawla, N.V., Bowyer, K.W., Hall, L.O., Kegelmeyer, W.P.: SMOTE: synthetic minority over-sampling technique. J. Artif. Intell. Res. 16, 321–357 (2002)CrossRefMATH Chawla, N.V., Bowyer, K.W., Hall, L.O., Kegelmeyer, W.P.: SMOTE: synthetic minority over-sampling technique. J. Artif. Intell. Res. 16, 321–357 (2002)CrossRefMATH
13.
Zurück zum Zitat López, V., Fernández, A., García, S., Palade, V., Herrera, F.: An insight into classification with imbalanced data: Empirical results and current trends on using data intrinsic characteristics. Inf. Sci. 250, 113–141 (2013)CrossRef López, V., Fernández, A., García, S., Palade, V., Herrera, F.: An insight into classification with imbalanced data: Empirical results and current trends on using data intrinsic characteristics. Inf. Sci. 250, 113–141 (2013)CrossRef
14.
Zurück zum Zitat Carpenter, C.R., Heard, K., Wilber, S., Ginde, A.A., Stiffler, K., Gerson, L.W., et al.: Research priorities for high-quality geriatric emergency care: medication management, screening, and prevention and functional assessment. Acad. Emerg. Med. 18(6), 644–654 (2011)CrossRef Carpenter, C.R., Heard, K., Wilber, S., Ginde, A.A., Stiffler, K., Gerson, L.W., et al.: Research priorities for high-quality geriatric emergency care: medication management, screening, and prevention and functional assessment. Acad. Emerg. Med. 18(6), 644–654 (2011)CrossRef
15.
Zurück zum Zitat Lopez-Aguila, S., Contel, J.C., Farre, J., Campuzano, J.L., Rajmil, L.: Predictive model for emergency hospital admission and 6-month readmission. Am. J. Manage. Care 17(9), e348–e357 (2011) Lopez-Aguila, S., Contel, J.C., Farre, J., Campuzano, J.L., Rajmil, L.: Predictive model for emergency hospital admission and 6-month readmission. Am. J. Manage. Care 17(9), e348–e357 (2011)
16.
Zurück zum Zitat Han, J.H., Zimmerman, E.E., Cutler, N., Schnelle, J., Morandi, A., Dittus, R.S., et al.: Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes. Acad. Emerg. Med. 16(3), 193–200 (2009)CrossRef Han, J.H., Zimmerman, E.E., Cutler, N., Schnelle, J., Morandi, A., Dittus, R.S., et al.: Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes. Acad. Emerg. Med. 16(3), 193–200 (2009)CrossRef
17.
Zurück zum Zitat New guidelines for geriatric EDs: guidance focused on boosting environment, care processes. ED Manage 26(5), 49–53 (2014) New guidelines for geriatric EDs: guidance focused on boosting environment, care processes. ED Manage 26(5), 49–53 (2014)
18.
Zurück zum Zitat Phuong, T.M., Lin, Z., Altman, R.B.: Choosing SNPs using feature selection. In: 2005 IEEE Computational Systems Bioinformatics Conference (CSB 2005), pp. 301–309. IEEE (2005) Phuong, T.M., Lin, Z., Altman, R.B.: Choosing SNPs using feature selection. In: 2005 IEEE Computational Systems Bioinformatics Conference (CSB 2005), pp. 301–309. IEEE (2005)
19.
Zurück zum Zitat Hall, M.A.: Correlation-based feature selection for machine learning (Doctoral dissertation, The University of Waikato) (1999) Hall, M.A.: Correlation-based feature selection for machine learning (Doctoral dissertation, The University of Waikato) (1999)
20.
Zurück zum Zitat Chawla, N.V., Bowyer, K.W., Hall, L.O., Kegelmeyer, W.P.: SMOTE: synthetic minority over-sampling technique. J. Artif. Intell. Res. 16, 321–357 (2002)CrossRefMATH Chawla, N.V., Bowyer, K.W., Hall, L.O., Kegelmeyer, W.P.: SMOTE: synthetic minority over-sampling technique. J. Artif. Intell. Res. 16, 321–357 (2002)CrossRefMATH
Metadaten
Titel
Predicting 30-Day Emergency Readmission Risk
verfasst von
Arkaitz Artetxe
Andoni Beristain
Manuel Graña
Ariadna Besga
Copyright-Jahr
2017
DOI
https://doi.org/10.1007/978-3-319-47364-2_1