The promise for reducing healthcare cost with predictive model: An analysis with quantized evaluation metric on readmission

Teo, Kareen and Yong, Ching Wai and Muhamad, Farina and Mohafez, Hamidreza and Hasikin, Khairunnisa and Xia, Kaijian and Qian, Pengjiang and Dhanalakshmi, Samiappan and Utama, Nugraha Priya and Lai, Khin Wee (2021) The promise for reducing healthcare cost with predictive model: An analysis with quantized evaluation metric on readmission. Journal of Healthcare Engineering, 2021. ISSN 2040-2295, DOI

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Quality of care data has gained transparency captured through various measurements and reporting. Readmission measure is especially related to unfavorable patient outcomes that directly bends the curve of healthcare cost. Under the Hospital Readmission Reduction Program, payments to hospitals were reduced for those with excessive 30-day rehospitalization rates. These penalties have intensified efforts from hospital stakeholders to implement strategies to reduce readmission rates. One of the key strategies is the deployment of predictive analytics stratified by patient population. The recent research in readmission model is focused on making its prediction more accurate. As cost-saving improvements through artificial intelligent-based health solutions are expected, the broad economic impact of such digital tool remains unknown. Meanwhile, reducing readmission rate is associated with increased operating expenses due to targeted interventions. The increase in operating margin can surpass native readmission cost. In this paper, we propose a quantized evaluation metric to provide a methodological mean in assessing whether a predictive model represents cost-effective way of delivering healthcare. Herein, we evaluate the impact machine learning has had on transitional care and readmission with proposed metric. The final model was estimated to produce net healthcare savings at over $1 million given a 50% rate of successfully preventing a readmission.

Item Type: Article
Funders: (China) Project on Promoting the Use of ICT for Achievement of Sustainable Development Goals and University Malaya[IF015-2021]
Uncontrolled Keywords: Hospital readmissions;Risk
Subjects: R Medicine
R Medicine > RA Public aspects of medicine
T Technology > TJ Mechanical engineering and machinery
Divisions: Faculty of Engineering
Depositing User: Ms Zaharah Ramly
Date Deposited: 13 Sep 2022 04:36
Last Modified: 13 Sep 2022 04:36

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