Hamburg Center for Health Economics, Universität Hamburg, Esplanade 36, 20354, Hamburg, Germany.
Department of Healthcare Management, Technische Universität Berlin, 10623, Berlin, Germany.
Health Care Manag Sci. 2019 Mar;22(1):85-105. doi: 10.1007/s10729-017-9423-5. Epub 2017 Nov 25.
Rising admissions from emergency departments (EDs) to hospitals are a primary concern for many healthcare systems. The issue of how to differentiate urgent admissions from non-urgent or even elective admissions is crucial. We aim to develop a model for classifying inpatient admissions based on a patient's primary diagnosis as either emergency care or elective care and predicting urgency as a numerical value. We use supervised machine learning techniques and train the model with physician-expert judgments. Our model is accurate (96%) and has a high area under the ROC curve (>.99). We provide the first comprehensive classification and urgency categorization for inpatient emergency and elective care. This model assigns urgency values to every relevant diagnosis in the ICD catalog, and these values are easily applicable to existing hospital data. Our findings may provide a basis for policy makers to create incentives for hospitals to reduce the number of inappropriate ED admissions.
急诊科(ED)向医院的入院人数不断增加,这是许多医疗保健系统的主要关注点。如何区分紧急入院和非紧急甚至选择性入院是至关重要的。我们旨在开发一种基于患者主要诊断的分类模型,将住院患者分为急诊护理或择期护理,并预测其紧急程度作为数值。我们使用监督机器学习技术,并使用医生专家的判断来训练模型。我们的模型准确率为 96%,ROC 曲线下面积较高(>.99)。我们提供了对住院患者急诊和择期护理的首次全面分类和紧急程度分类。该模型为 ICD 目录中的每个相关诊断分配紧急值,这些值可轻松应用于现有医院数据。我们的研究结果可能为决策者提供依据,制定激励措施,促使医院减少不适当的 ED 入院人数。