Re-hospitalization factors and economic characteristics of urinary tract infected patients using machine learning

Author:

Lee Yul Hee1ORCID,Baik Young Seo2,Kim Young Jae3ORCID,Shi Hye Jin4,Moon Jong Youn56,Kim Kwang Gi78ORCID

Affiliation:

1. Department of Nursing, Gachon University, Incheon, Korea

2. Department of Biomedical Engineering, Gachon University, Republic of Korea

3. Gachon Biomedical & Convergence Institute, Gachon University Gil Medical Center, Incheon, Korea

4. Division of Infectious Disease, Department of Internal Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea

5. Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Korea

6. Center for Public Healthcare, Gachon University Gil Medical Center, Incheon, Korea

7. Department of Biomedical Engineering, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea

8. Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences and Technology, Gachon University, Seongnam-si, Korea

Abstract

Objective Urinary tract infection is one of the most prevalent bacterial infectious diseases in outpatient treatment, and 50–80% of women experience it more than once, with a recurrence rate of 40–50% within a year; consequently, preventing re-hospitalization of patients is critical. However, in the field of urology, no research on the analysis of the re-hospitalization status for urinary tract infections using machine learning algorithms has been reported to date. Therefore, this study uses various machine learning algorithms to analyze the clinical and nonclinical factors related to patients who were re-hospitalized within 30 days of urinary tract infection. Methods Data were collected from 497 patients re-hospitalized for urinary tract infections within 30 days and 496 patients who did not require re-hospitalization. The re-hospitalization factors were analyzed using four machine learning algorithms: gradient boosting classifier, random forest, naive Bayes, and logistic regression. Results The best-performing gradient boosting classifier identified respiratory rate, days of hospitalization, albumin, diastolic blood pressure, blood urea nitrogen, body mass index, systolic blood pressure, body temperature, total bilirubin, and pulse as the top-10 factors that affect re-hospitalization because of urinary tract infections. The 993 patients whose data were collected were divided into risk groups based on these factors, and the re-hospitalization rate, days of hospitalization, and medical expenses were observed to decrease from the high- to low-risk group. Conclusions This study showed new possibilities in analyzing the status of urinary tract infection-related re-hospitalization using machine learning. Identifying factors affecting re-hospitalization and incorporating preventable and reinforcement-based treatment programs can aid in reducing the re-hospitalization rate and average number of days of hospitalization, thereby reducing medical expenses.

Funder

GRRC program of Gyeonggi province

Publisher

SAGE Publications

Reference34 articles.

1. Agency for Healthcare Research and Quality. Prevention quality indicators measures, https://qualityindicators.ahrq.gov/measures/pqi_resources (accessed 30 December 2019).

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3. Development of a predictive model to identify inpatients at risk of re-admission within 30 days of discharge (PARR-30)

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