An Interpretable Algorithm on Post-injury Health Service Utilization Patterns to Predict Injury Outcomes.

Purpose Post-injury health service utilization (HSU) contributes to injury outcomes, but limited studies investigated their relationship. This study aims to group injured patients in transport accidents based on minimal historical information of their HSU so that the groups are meaningfully associat...

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Published in:Journal of Occupational Rehabilitation Vol. 30; no. 3; pp. 331 - 343
Main Authors: Akbarzadeh Khorshidi, Hadi, Hassani-Mahmooei, Behrooz, Haffari, Gholamreza
Format: research tables/charts Journal Article
Published: Springer Nature Sep2020
Online Access:View this record in EBSCOhost
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      dt: Sep2020
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10926-019-09863-0
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        atl: An Interpretable Algorithm on Post-injury Health Service Utilization Patterns to Predict Injury Outcomes.
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        au:
          Akbarzadeh Khorshidi, Hadi
          Hassani-Mahmooei, Behrooz
          Haffari, Gholamreza
        affil: School of Computing and Information Systems, The University of Melbourne, Melbourne, Australia
      sug:
        subj:
          Algorithms
          Occupational-Related Injuries
          Health Services Utilization
          Patient Classification Methods
          Transportation
          Accidents, Occupational
          Prediction Models
          Outcomes (Health Care)
          Human
          Funding Source
          Machine Learning Methods
          Accidental Injuries
          Decision Trees
          Cluster Analysis
          Descriptive Statistics
          Regression
          Health Care Costs
          Recovery
          Severity of Injury
          Adolescence
          Adult
          Middle Age
          Aged
          Male
          Female
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Purpose Post-injury health service utilization (HSU) contributes to injury outcomes, but limited studies investigated their relationship. This study aims to group injured patients in transport accidents based on minimal historical information of their HSU so that the groups are meaningfully associated with the outcome of interest. Methods The data include 20,692 injured patients who had compensation claims over 3 years. We propose a hybrid approach, combining unsupervised and supervised machine learning methods. Based on the first week post-injury data, we identify a proper clustering of patients best associated with total cost to recovery, as well as the discovery of HSU patterns. This allows developing models to accurately predict the outcome of interest using the discovered patterns. Furthermore, we propose to use decision tree classifiers to accurately classify future patients into the discovered clusters using their first week post-injury information. Results Our hybrid approach has identified eight patient groups. The compactness of the resulted clusters, assessed by Average Silhouette Width metric, is 0.71 indicating well-defined clusters. The resulted patient groups are highly predictive of injury outcomes. They improve the cost predictability more than twice in comparison with predictors such as gender, age and injury type. These groups also have substantial association with patients' recovery. The transparency and interpretability of decision trees allow integrating the resulting classification rules conveniently in operational processes. Conclusions This study provides a framework to discover knowledge and useful insights for health service providers and policy makers to control injury outcomes, and consequently to reduce the severity of transport accidents.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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