Gao Cheng, Kho Abel N, Ivory Catherine, Osmundson Sarah, Malin Bradley A, Chen You
Dept. of Biomedical Informatics, School of Medicine, Vanderbilt University, Nashville, TN, USA.
Institute for Public Health and Medicine, Northwestern University, Chicago, IL, USA.
Stud Health Technol Inform. 2017;245:1019-1023.
Obstetric care refers to the care provided to patients during ante-, intra-, and postpartum periods. Predicting length of stay (LOS) for these patients during their hospitalizations can assist healthcare organizations in allocating hospital resources more effectively and efficiently, ultimately improving maternal care quality and reducing costs to patients. In this paper, we investigate the extent to which LOS can be forecast from a patient's medical history. We introduce a machine learning framework to incorporate a patient's prior conditions (e.g., diagnostic codes) as features in a predictive model for LOS. We evaluate the framework with three years of historical billing data from the electronic medical records of 9188 obstetric patients in a large academic medical center. The results indicate that our framework achieved an average accuracy of 49.3%, which is higher than the baseline accuracy 37.7% (that relies solely on a patient's age). The most predictive features were found to have statistically significant discriminative ability. These features included billing codes for normal delivery (indicative of shorter stay) and antepartum hypertension (indicative of longer stay).
产科护理是指在产前、产时和产后为患者提供的护理。预测这些患者住院期间的住院时长(LOS)有助于医疗机构更有效、高效地分配医院资源,最终提高孕产妇护理质量并降低患者成本。在本文中,我们研究了根据患者病史预测住院时长的程度。我们引入了一个机器学习框架,将患者的既往病症(如诊断代码)作为住院时长预测模型的特征。我们使用来自一家大型学术医疗中心9188名产科患者电子病历的三年历史计费数据对该框架进行评估。结果表明,我们的框架平均准确率达到49.3%,高于仅依赖患者年龄的基线准确率37.7%。发现最具预测性的特征具有统计学上显著的判别能力。这些特征包括正常分娩的计费代码(表明住院时间较短)和产前高血压(表明住院时间较长)。