Modeling acute care utilization: practical implications for insomnia patients.

Journal: Scientific reports
Published Date:

Abstract

Machine learning models can help improve health care services. However, they need to be practical to gain wide-adoption. In this study, we investigate the practical utility of different data modalities and cohort segmentation strategies when designing models for emergency department (ED) and inpatient hospital (IH) visits. The data modalities include socio-demographics, diagnosis and medications. Segmentation compares a cohort of insomnia patients to a cohort of general non-insomnia patients under varying age and disease severity criteria. Transfer testing between the two cohorts is introduced to demonstrate that an insomnia-specific model is not necessary when predicting future ED visits, but may have merit when predicting IH visits especially for patients with an insomnia diagnosis. The results also indicate that using both diagnosis and medications as a source of data does not generally improve model performance and may increase its overhead. Based on these findings, the proposed evaluation methodologies are recommended to ascertain the utility of disease-specific models in addition to the traditional intra-cohort testing.

Authors

  • Farid Chekani
    Merck & Co., Inc., Rahway, NJ, 07065, USA.
  • Zitong Zhu
    Computer Science, IUPUI, Indianapolis, IN, 46202, USA.
  • Rezaul Karim Khandker
    Merck & Co., Inc., Rahway, NJ, 07065, USA.
  • Jizhou Ai
    Merck & Co., Inc., Rahway, NJ, 07065, USA.
  • Weilin Meng
    Merck & Co., Inc., Rahway, NJ, 07065, USA.
  • Emma Holler
    School of Public Health, Indiana University, Bloomington, IN, 47405, USA.
  • Paul Dexter
    Regenstrief Institute Inc., Indianapolis, IN.
  • Malaz Boustani
    School of Medicine, Indiana University, Indianapolis, IN, 46202, USA.
  • Zina Ben Miled
    Regenstrief Institute, Indianapolis, IN, 46202, USA. zmiled@iupui.edu.