Patient expenditure prediction using deep learning framework

https://doi.org/10.53730/ijhs.v6nS4.9109

Authors

  • K Sasi Vijaya Asst Prof CSE, BVCEC
  • Gunamani Jena Prof CSE, BVCEC
  • Tirumani Vannika CSE, BVCEC
  • Tula Manu Akhil CSE, BVCEC
  • Undru Balapraveen CSE, BVCEC
  • Tanneedi Anjan Sai Chaitanya CSE, BVCEC

Keywords:

deep learning, electronic health records, spending prediction, machine learning, analyse administrative claims data

Abstract

Measurement of patient expenditure in healthcare is a critical task that has a variety of applications, including provider profiling, accountable care management, and capitated medical payment adjustment. Currently available methods rely on manually built features and linear regression-based models, both of which need a significant amount of medical domain expertise. and have low prediction accuracy. This study develops a multi-view deep learning system for forecasting future healthcare costs at the individual level based on prior claims data. Our multi-view technique efficiently models heterogeneous data such patient demographics, medical codes, medication usages, and facility usage. To execute spending forecasting tasks, we employed a real-world paediatric dataset with approximately 450,000 patients. According to the empirical data, our proposed technique beats all baselines for predicting medical cost. In the sphere of healthcare, these insights help to improve preventative and responsible care.

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References

M. A. Morid, O. R. L. Sheng, K. Kawamoto, T. Ault, J. Dorius, and S. Abdelrahman, “Healthcare cost prediction: Leveraging fine-grain temporal patterns,” J. Biomed. Inform., vol. 91, 2019, Art. no. 103113.

A. S. Ash et al., “Using diagnoses to describe populations and predict costs,” Health Care Financing Rev., vol. 21, pp. 7–28, 2000.

M. E. Cowen, D. J. Dusseau, B. G. Toth, C. Guisinger, M. W. Zodet, and Y. Shyr, “Casemix adjustment of managed care claims data using the clinical classification for health policy research method,” Med. Care, vol. 36, pp. 1108–1113, 1998.

A. K. Rosen, S. A. Loveland, J. J. Anderson, C. S. Hankin, J. N. Breckenridge, and D. R. Berlowitz, “Diagnostic cost groups (DCGs) and concurrent utilization among patients with substance abuse disorders,” Health Serv. Res., vol. 37, pp. 1079–1103, 2002.

D. Bertsimas et al., “Algorithmic prediction of health-care costs,” Oper. Res., vol. 56, pp. 1382–1392, 2008.

D. O. Clark, M. Von Korff, K. Saunders, W. M. Balugh, and G. E. Simon, “A chronic disease score with empirically derived weights,” Med. Care, pp. 783–795, 1995, doi: 10.1097/00005650-199508000-00004

M. Von Korff, E. H. Wagner, and K. Saunders, “A chronic disease score from automated pharmacy data,” J. Clin. Epidemiol., vol. 45, pp. 197–203, 1992.

P. A. Fishman, M. J. Goodman, M. C. Hornbrook, R. T. Meenan, D. J. Bachman, M. C. O’Keeffe Rosetti, “Risk adjustment using automated ambulatory pharmacy data: The RxRisk model,” Med. Care, vol. 41, pp. 84–99, 2003.

J. P. Weiner, B. H. Starfield, D. M. Steinwachs, and L. M. Mumford, “Development and application of a population-oriented measure of ambulatory care case-mix,” Med. Care, pp. 452–472, 1991, doi: 10.1097/00005650-199105000-00006

Y. Zhao et al., “Measuring population health risks using inpatient diagnoses and outpatient pharmacy data,” Health Serv. Res., vol. 36, pp. 180–193, 2001.

Y. Zhao et al., “Predicting pharmacy costs and other medical costs using diagnoses and drug claims,” Med. Care, vol. 43, pp. 34–43, 2005.

C. Yang, C. Delcher, E. Shenkman, and S. Ranka, “Machine learning approaches for predicting high cost high need patient expenditures in health care,” Biomed. Eng. Online, vol. 17, no. 1, pp. 1–20, 2018, doi: 10.1186/s12938-018-0568-3

C.-Y. Kuo, L.-C. Yu, H.-C. Chen, and C.-L. Chan, “Comparison of models for the prediction of medical costs of spinal fusion in Taiwan diagnosis-related groups by machine learning algorithms,” Healthcare Inform. Res., vol. 24, no. 1, 2018, Art. no. 29.

I. Duncan, M. Loginov, and M. Ludkovski, “Testing alternative regression frameworks for predictive modeling of health care costs,” North Amer. Actuarial J., vol. 20, no. 1, pp. 65–87, 2016.

C. Wu, F. Wu, Y. Huang, and X. Xie, “NICE: Neural in-hospital cost estimation from medical records,” in Proc. 28th ACM Int. Conf. Inf. Knowl. Manage., 2019, doi: 10.1145/3357384.3358130

F. Wang, N. Lee, J. Hu, J. Sun, and S. Ebadollahi, “Towards heterogeneous temporal clinical event pattern discovery,” in Proc. 18th ACM SIGKDD Int. Conf. Knowl. Discov. Data Mining, 2012, doi: 10.1145/2339530.2339605

J. Zhou, F. Wang, J. Hu, and J. Ye, “From micro to macro,” in Proc. 20th ACM SIGKDD Int. Conf. Knowl. Discov. Data Mining, 2014, doi: 10.1145/2623330.2623711

P. Nguyen, T. Tran, N. Wickramasinghe, and S. Venkatesh, “Deepr: A convolutional net for medical records,” IEEE J. Biomed. Health Inform., vol. 21, no. 1, pp. 22–30, Jan. 2017.

E. Choi, M. T. Bahadori, E. Searles, C. Coffey, and J. Sun, “Multilayer representation learning for medical concepts,” in Proc. 22nd ACM SIGKDD Int. Conf. Knowl. Discovery Data Mining, 2016, pp. 1495– 1504.

C. Che, C. Xiao, J. Liang, B. Jin, J. Zho, and F. Wang, “An RNN architecture with dynamic temporal matching for personalized predictions of parkinson’s disease,” in Proc. 2017 SIAM Int. Conf. Data Mining, 2017, pp. 198–206.

Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Get vaccinated when it is your turn and follow the local guidelines. International Journal of Health Sciences, 5(3), x-xv. https://doi.org/10.53730/ijhs.v5n3.2938

Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Health and treatment of diabetes mellitus. International Journal of Health Sciences, 5(1), i-v. https://doi.org/10.53730/ijhs.v5n1.2864

Parmin, P., Suarayasa, K., & Wandira, B. A. (2020). Relationship between quality of service with patient loyality at general polyclinic of kamonji public health center. International Journal of Health & Medical Sciences, 3(1), 86-91. https://doi.org/10.31295/ijhms.v3n1.157

Published

17-06-2022

How to Cite

Vijaya, K. S., Jena, G., Vannika, T., Akhil, T. M., Balapraveen, U., & Chaitanya, T. A. S. (2022). Patient expenditure prediction using deep learning framework. International Journal of Health Sciences, 6(S4), 4528–4540. https://doi.org/10.53730/ijhs.v6nS4.9109

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Peer Review Articles

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