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Solving the Revolving Door Problem: Machine Learning for Readmission Risk Assessment

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Human Interaction, Emerging Technologies and Future Applications II (IHIET 2020)

Part of the book series: Advances in Intelligent Systems and Computing ((AISC,volume 1152))

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Abstract

In 2012 the United States passed legislation, penalizing hospitals for readmission of patients discharged within 30 days. However, many unknowns mean that hospitals cannot predict when each patient is appropriate to discharge. Through researching readmissions across the Thomas Jefferson University Hospital enterprise, we found that staff must make judgement calls based on their own clinical perspectives. Rather than expecting doctors to somehow intuit the interaction effects from thousands of variables, we surface trends and present strategies for mitigating readmission risks through machine learning (ML). Commonly, ML models are trained against data aggregated from various sources. This method of sourcing interferes with responding to population-based risk factors and variables that are specific to the hospital of interest. However, creating a custom model presents its own set of hurdles. The work of our team provides hospitals everywhere with an end-to-end pipeline to create a readmissions assessment tool, using their own data.

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References

  1. Robinson, R., Hudali, T.: The HOSPITAL score and LACE index as predictors of 30-day readmission in a retrospective study at a university-affiliated community hospital. PeerJ 5, e3137 (2017). https://doi.org/10.7717/peerj.3137

    Article  Google Scholar 

  2. van Walraven, C., Dhalla, I.A., Bell, C., Etchells, E., Stiell, I.G., Zarnke, K., Forster, A.J.: Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. Cmaj 182(6), 551–557 (2010). https://doi.org/10.1503/cmaj.091117

    Article  Google Scholar 

  3. Donzé, J.D., Williams, M.V., Robinson, E.J., et al.: International validity of the HOSPITAL score to predict 30-day potentially avoidable hospital readmissions. JAMA Intern. Med. 176(4), 496–502 (2016). https://doi.org/10.1001/jamainternmed.2015.8462

    Article  Google Scholar 

  4. Morgan, D.J., Bame, B., Zimand, P., et al.: Assessment of machine learning vs standard prediction rules for predicting hospital readmissions. JAMA Netw. Open. 2(3), e190348 (2019). 10.1001/jamanetworkopen.2019.0348

    Article  Google Scholar 

  5. Amarasingham, R., Moore, B.J., Tabak, Y.P., Drazner, M.H., Clark, C.A., Zhang, S., Halm, E.A.: An automated model to identify heart failure patients at risk for 30-day readmission or death using electronic medical record data. Med. Care 48(11), 981–988 (2010). https://doi.org/10.1097/MLR.0b013e3181ef60d9. PMID: 20940649. Issn Print: 0025-7079

    Article  Google Scholar 

  6. Holloway, J.J., Thomas, J.W., Shapiro, L.: Clinical and sociodemographic risk factors for readmission of medicare beneficiaries. Health Care Finan. Rev. 10(1), 27–36 (1988)

    Google Scholar 

  7. Makam, A.N., Nguyen, O.K., Clark, C., Zhang, S., Xie, B., Mark Weinreich, M.D., Mortensen, E.M., Halm, E.A.: Predicting 30-day pneumonia readmissions using electronic health record data. J. Hosp. Med. 4, 209–216 (2017). https://doi.org/10.12788/jhm.2711

    Article  Google Scholar 

  8. Steventon, A., Billings, J.: Preventing hospital readmissions: the importance of considering ‘impactibility’, not just predicted risk. BMJ Qual. Saf. 26, 782–785 (2017)

    Article  Google Scholar 

  9. Goldfield, N.I., McCullough, E.C., Hughes, J.S., et al.: Identifying potentially preventable readmissions. Health Care Finan. Rev. 30(1), 75–91 (2008)

    Google Scholar 

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Correspondence to Alexander Mitts .

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Mitts, A., D’souza, T., Sadler, B., Battistini, D., Vuong, D. (2020). Solving the Revolving Door Problem: Machine Learning for Readmission Risk Assessment. In: Ahram, T., Taiar, R., Gremeaux-Bader, V., Aminian, K. (eds) Human Interaction, Emerging Technologies and Future Applications II. IHIET 2020. Advances in Intelligent Systems and Computing, vol 1152. Springer, Cham. https://doi.org/10.1007/978-3-030-44267-5_15

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  • DOI: https://doi.org/10.1007/978-3-030-44267-5_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44266-8

  • Online ISBN: 978-3-030-44267-5

  • eBook Packages: EngineeringEngineering (R0)

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