在医疗保险优势计划中预测患者死亡率,以便更早地识别息护理:机器学习模型的特点
Anne Bowers1, Chelsea Drake1, Alexi E Makarkin1
1Evernorth Health, Inc, St. Louis, MO, United States.
JMIR AI
|June 14, 2024
概括
机器学习模型可以比仅靠提供者判断更准确地预测医疗保险患者的生命终点. 纳入健康的社会决定因素可以改善这些预测,以便更好地识别息护理.
科学领域:
- 老年学是一门学科.
- 医疗信息学 医疗信息学
- 机器学习 机器学习
背景情况:
- 机器学习 (ML) 为预测医疗保险受益人生命末期和息护理需求提供了更高的准确性.
- 之前的ML研究还没有充分探索特征影响或健康社会决定因素的作用.
研究的目的:
- 开发一个二进制分类ML模型来预测65岁及以上的Medicare Advantage会员的1年死亡率.
- 检查影响ML模型预测准确性的关键特征.
主要方法:
- 一个轻度梯度增强树木模型被开发并使用5倍交叉验证进行验证.
- 该模型利用了907个来自索赔和行政数据的特征,包括人口统计和健康的社会决定因素.
- 培训数据包括80%的案例 (n=255,020),其中20% (n=63,754) 被用于验证.
主要成果:
- 该模型在预测死亡率时达到0.84的AUC (95% CI 0.83-0.85).
- 最重要的预测特征包括患者人口统计,诊断,药房利用率,成本和健康的社会决定因素.
- 该模型准确预测了最高风险的1%患者中44.2%的死亡.
结论:
- 开发的ML模型有效地预测了Medicare Advantage会员的生命终点.
- 该模型利用常规收集的数据,能够更早地识别息护理服务.
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