Machine-learning prediction for hospital length of stay using a French medico-administrative database

Autor: Franck Jaotombo, Vanessa Pauly, Guillaume Fond, Veronica Orleans, Pascal Auquier, Badih Ghattas, Laurent Boyer
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Market Access & Health Policy, Vol 11, Iss 1 (2023)
Druh dokumentu: article
ISSN: 20016689
2001-6689
DOI: 10.1080/20016689.2022.2149318
Popis: ABSTRACTIntroduction: Prolonged Hospital Length of Stay (PLOS) is an indicator of deteriorated efficiency in Quality of Care. One goal of public health management is to reduce PLOS by identifying its most relevant predictors. The objective of this study is to explore Machine Learning (ML) models that best predict PLOS.Methods: Our dataset was collected from the French Medico-Administrative database (PMSI) as a retrospective cohort study of all discharges in the year 2015 from a large university hospital in France (APHM). The study outcomes were LOS transformed into a binary variable (long vs. short LOS) according to the 90th percentile (14 days). Logistic regression (LR), classification and regression trees (CART), random forest (RF), gradient boosting (GB) and neural networks (NN) were applied to the collected data. The predictive performance of the models was evaluated using the area under the ROC curve (AUC).Results: Our analysis included 73,182 hospitalizations, of which 7,341 (10.0%) led to PLOS. The GB classifier was the most performant model with the highest AUC (0.810), superior to all the other models (all p-values
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