Predicting 30-Day Risk and Cost of "All-Cause" Hospital Readmissions

Shanu Sushmita, Garima Khulbe, Aftab Hasan, Stacey Newman, Padmashree Ravindra, Senjuti Basu Roy, Martine De Cock, Ankur Teredesai

Abstract: The hospital readmission rate of patients within 30 days after discharge is broadly accepted as a healthcare quality measure and cost driver in the United States. The ability to estimate hospitalization costs alongside 30 day risk-stratification for such readmissions provides additional benefit for accountable care, now a global issue and foundation for the U.S.~government mandate under the Affordable Care Act. Recent data mining efforts either predict healthcare costs or risk of hospital readmission, but not both. In this paper we present a dual predictive modeling effort that utilizes healthcare data to predict the risk and cost of any hospital readmission (``all-cause''). For this purpose, we explore machine learning algorithms to do accurate predictions of healthcare costs and risk of 30-day readmission.Results on risk prediction for ``all-cause'' readmission compared to the standardized readmission tool (LACE) are promising, and the proposed techniques for cost prediction consistently outperform baseline models and demonstrate substantially lower mean absolute error (MAE).