Developing Prediction Models for 30-Day Readmission after Stroke among Medicare Beneficiaries

Rahmati, Monireh; Cho, Jin; Fell, Nancy; Sartipi, Mina

doi:10.1109/southeastcon48659.2022.9763936

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…8,9 The extreme gradient boosting method (XGBoost) is a promising nonparametric tree-based algorithm. [10][11][12][13][14] Compared with regression-based algorithms (eg, logistic regression), XGBoost has several strengths that can benefit-risk-adjustment methods. In logistic regression, human decisions are needed to determine what factors go into the risk-adjustment model.…”

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confidence: 99%

“…Machine learning is a novel computational method for automatic learning from experience to improve model performance 8,9 . The extreme gradient boosting method (XGBoost) is a promising nonparametric tree-based algorithm 10–14 . Compared with regression-based algorithms (eg, logistic regression), XGBoost has several strengths that can benefit–risk-adjustment methods.…”

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confidence: 99%

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Developing a Machine Learning Risk-adjustment Method for Hospitalizations and Emergency Department Visits of Nursing Home Residents With Dementia

Bowblis

Becerra

et al. 2023

Medical Care

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Background: Long-stay nursing home (NH) residents with Alzheimer disease and related dementias (ADRD) are at high risk of hospital transfers. Machine learning might improve risk-adjustment methods for NHs. Objectives: The objective of this study was to develop and compare NH risk-adjusted rates of hospitalizations and emergency department (ED) visits among long-stay residents with ADRD using Extreme Gradient Boosting (XGBoost) and logistic regression. Research Design: Secondary analysis of national Medicare claims and NH assessment data in 2012 Q3. Data were equally split into the training and test sets. Both XGBoost and logistic regression predicted any hospitalization and ED visit using 58 predictors. NH-level risk-adjusted rates from XGBoost and logistic regression were constructed and compared. Multivariate regressions examined NH and market factors associated with rates of hospitalization and ED visits. Subjects: Long-stay Medicare residents with ADRD (N=413,557) from 14,057 NHs. Results: A total of 8.1% and 8.9% residents experienced any hospitalization and ED visit in a quarter, respectively. XGBoost slightly outperformed logistic regression in area under the curve (0.88 vs. 0.86 for hospitalization; 0.85 vs. 0.83 for ED visit). NH-level risk-adjusted rates from XGBoost were slightly lower than logistic regression (hospitalization=8.3% and 8.4%; ED=8.9% and 9.0%, respectively), but were highly correlated. Facility and market factors associated with the XGBoost and logistic regression-adjusted hospitalization and ED rates were similar. NHs serving more residents with ADRD and having a higher registered nurse-to-total nursing staff ratio had lower rates. Conclusions: XGBoost and logistic regression provide comparable estimates of risk-adjusted hospitalization and ED rates.

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