点击率预测问题建模_使用预测建模技术预测住院率

点击率预测问题建模

机器学习(Machine Learning)

Hospital readmissions, particularly unplanned hospital readmissions are costly to the health care industry. Centers for Medicare and Medicaid Services (CMS) reporting an annual $17 billion in health care spending as a result of hospital readmissions. CMS outlined chronic conditions with a high risk of frequent hospitalizations/readmissions as part of the 2010 Hospital Readmission Reduction Program.

^ h ospital再住院，特别是计划外再入院是昂贵的医疗保健行业。 医疗保险和医疗补助服务中心(CMS)报告，由于医院再次入院，每年在医疗保健方面的支出为170亿美元。 CMS概述了慢性病，这是经常住院/再入院的高风险，是2010年医院再入院减少计划的一部分。

The rise of EHR technology aided in tracking and capturing of patient data, particularly patients that fell into the category of “high risk” for readmission. Considering the CMS’s outline of chronic conditions and the use of EHR technology, the stage was set for the question of the possibility to predict readmissions.

EHR技术的兴起有助于跟踪和捕获患者数据，特别是那些属于再次入院“高风险”类别的患者。 考虑到CMS的慢性病概述和EHR技术的使用，为预测再入院的可能性问题设定了阶段。

The accuracy of predicting readmissions varies across predictive modeling techniques. Predicting readmissions has since evolved from the standard hospital administrative risk assessments such as LACE to machine learning techniques. Machine learning techniques varying from the baseline model of Logistic Regression to more advanced and complicated models such as Deep Neural Networks.

预测再入院的准确性因预测建模技术而异。 此后，重新入学的预测已从标准的医院行政风险评估(例如LACE)演变为机器学习技术。 机器学习技术从Logistic回归的基线模型到更高级和复杂的模型(如深度神经网络)不等。

The objective of this literature review is to discuss the most commonly used predictive modeling strategies and their accuracy in predicting hospital readmissions.

这篇文献综述的目的是讨论最常用的预测建模策略及其在预测住院率方面的准确性。

The databases used in the search for relevant articles were: Adelphi University Library Online Database (OneSearch), PubMed, Google Scholar, ScienceDirect, Wiley Online Library as well as British Medical Journal, New England Medical Journal, JAMA Network, Springer Link, and PLOS One. 35 articles were discovered matching the keywords, however after reviewing the type of article (ie, relevance, year article was written- articles written > 20 years were excluded, articles that were not peer-reviewed were also excluded) the articles were then narrowed down to 27.

搜索相关文章时使用的数据库为：阿德菲大学图书馆在线数据库(OneSearch)，PubMed，Google Scholar，ScienceDirect，Wiley在线图书馆以及《英国医学杂志》，《新英格兰医学杂志》，JAMA Network，Springer Link和PLOS一。 发现35个与关键字匹配的文章，但是在审查了文章类型之后(即，相关性，撰写年份文章-排除了写作> 20年的文章，也排除了未经同行评审的文章)，然后缩小了文章的范围至27。

The overall consensus was deep neural networks outperformed traditional predictive modeling techniques such as LACE and machine learning (Logistic Regression). There is still much to be learned to improve predictive modeling. Health care is complex and the system is not one size fits all, there is a need to take into consideration patient health conditions and other factors that influence health care outcomes.

总体共识是，深度神经网络优于传统的预测建模技术，例如LACE和机器学习(逻辑回归)。 改善预测模型仍有很多知识要学习。 卫生保健很复杂，而且该系统并不是一个适合所有人的规模，因此需要考虑患者的健康状况和其他影响卫生保健结果的因素。

Factors such as social and economics play a role in health care outcomes. These factors have been known to typically be excluded in predictive modeling techniques/strategies, however, research suggests that such factors have an impact on health care outcomes and predictive modeling techniques.

社会和经济因素在医疗保健结果中发挥作用。 众所周知，这些因素通常在预测建模技术/策略中不包括在内，但是研究表明，这些因素会对医疗保健结果和预测建模技术产生影响。

The future of predictive modeling in health care is a system that is able to take into consideration the patient as a whole, while factoring patient social and economic barriers/status in order to improve patient predictions.

卫生保健中的预测建模的未来是一个能够考虑到患者整体的系统，同时考虑到患者的社会和经济障碍/状况以改善患者预测。

介绍 (Introduction)

Hospital readmissions continue to greatly account for health care spending in the United States. Many of the readmissions, according to Centers for Medicare and Medicaid Services (CMS), are considered avoidable and preventable. Frequent hospital readmissions indicate a lack of quality care, poor discharge planning, as well as a wealth of other social and economic factors which may have an effect on readmissions rates.

住院再入院继续在美国占医疗保健支出的很大比例。 根据医疗保险和医疗补助服务中心(CMS)的说法，许多重新入院被认为是可以避免和预防的。 频繁的医院再入院表明缺乏优质的医疗服务，出院计划不佳以及其他许多可能影响再入院率的社会和经济因素。

CMS created the Hospital Readmission Reduction Program (HRRP) in 2010 in an effort to reduce frequent hospital readmissions. The program focuses on reducing Medicare payments if a patient is readmitted to a hospital within 30 days from discharge date and the readmission is c