skip to main content
10.1145/3498731.3498755acmotherconferencesArticle/Chapter ViewAbstractPublication PagesicbbsConference Proceedingsconference-collections
research-article

Use of machine learning to predict abandonment rates in an emergency department

Authors Info & Claims
Published:26 January 2022Publication History

ABSTRACT

Overcrowding is a serious issue that Emergency Departments (EDs) must deal with, since it is leading to longer delays and greater patients’ dissatisfaction, which are directly connected with an increasing number of patients who leave the ED prematurely. Hospital is affected by this aspect in terms of lost revenues from opportunities missed in providing care and adverse outcomes deriving from ED process. For this reason, the ability to control and predict in advance patients who leave ED without any evaluation becomes strategic for healthcare administrators. The purpose of this work is to investigate causes that determine patients who leave the ED without being seen. Machine Learning algorithms are used in order to build and compare different models for LWBS prediction, with the aim of obtaining a helpful support tool for the ED management in healthcare facilities.

References

  1. P.V. Asaro, L.M. Lewis, and S.B. Boxerman, 'Emergency department overcrowding: analysis of the factors of renege rate', Acad. Emerg. Med., vol. 14, pp. 157–62, 2007, doi: 10.1197/j.aem.2006.08.011.Google ScholarGoogle ScholarCross RefCross Ref
  2. S.J. Weiss, A.A. Ernst, R. Derlet, , 'Relationship between the National ED Overcrowding Scale and the number of patients who leave without being seen in an academic ED', Am. J. Emerg. Med., vol. 23, pp. 288-294, 2005, doi: 10.1016/j.ajem.2005.02.034.Google ScholarGoogle ScholarCross RefCross Ref
  3. R. Ding, M.L. McCarthy, G.Li, , 'Patients who leave without being seen: their characteristics and history of emergency department use', Ann. Emerg. Med., vol. 48, pp. 686-693, 2006, doi: 10.1016/j.annemergmed.2006.05.022.Google ScholarGoogle ScholarCross RefCross Ref
  4. B.H. Rowe, P. Channan, M. Bullard, , 'Characteristics of patients who leave emergency departments without being seen', Acad. Emerg. Med., vol. 13, 848–852, 2006, doi: 10.1197/j.aem.2006.01.028.Google ScholarGoogle ScholarCross RefCross Ref
  5. D.W. Baker, C.D. Steven, R.H. Brook, 'Patient who leave a public hospital ED without being seen: causes and consequences', JAMA, vol. 266, pp. 1085-90, 1991, doi: 10.1001/jama.1991.03470080055029.Google ScholarGoogle Scholar
  6. R.Y. Hsia, S.M. Asch, R.E. Weiss, , 'Hospital determinants of emergency department left without being seen rates', Ann. Emerg. Med., vol. 58, pp. 24-32, 2011, 10.1016/j.annemergmed.2011.01.009.Google ScholarGoogle ScholarCross RefCross Ref
  7. A.E. Bair, W.T. Song, Y. Chen, and B.A. Morris, 'The Impact of Inpatient Boarding on ED Efficiency: A Discrete-Event Simulation Study', J. Med. Sys., vol. 34, pp. 919-929, 2010, doi: 10.1007/s10916-009-9307-4.Google ScholarGoogle ScholarDigital LibraryDigital Library
  8. N.K. Rathlev, P. Visintainer, J. Schmidt, , 'Patient Characteristics and Clinical Process Predictors of Patients Leaving Without Being Seen from the Emergency Department', West J. Emerg. Med., vol. 21, pp. 1218-1226, 2020, doi: 10.5811/westjem.2020.6.47084.Google ScholarGoogle Scholar
  9. J.C. Pham, G.K. Ho, P.M. Hill, M.L. McCarthy, and P.J. Pronovost, 'National study of patient, visit, and hospital characteristics associated with leaving an emergency department without being seen: predicting LWBS', Acad. Emerg. Med., vol. 16, pp. 949-955, 2009, doi: 10.1111/j.1553-2712.2009.00515.x.Google ScholarGoogle ScholarCross RefCross Ref
  10. J. Tropea, V. Sundarajan, A. Gorelik, 'Patient who leave without being seen in emergency departments: an analysis of predictive factors and outcomes', Acad Emerg Med, vol. 19, pp. 439-447, 2012, doi: 10.1111/j.1553-2712.2012.01327.x.Google ScholarGoogle ScholarCross RefCross Ref
  11. C. Ricciardi, A. M. Ponsiglione, G. Converso, I. Santalucia, M. Triassi, and G. Improta, ‘Implementation and validation of a new method to model voluntary departures from emergency departments’, Math. Biosci. Eng., vol. 18, no. 1, Art. no. mbe-18-01-013, 2021, doi: 10.3934/mbe.2021013.Google ScholarGoogle Scholar
  12. J. Monzon, S.M. Friedman, C. Clarke, and T. Arenovich, 'Patients who leave the emergency department without being seen by a physician: a control-matched study', Can. J. Emerg. Med., vol. 7, pp. 107-113, 2005, doi: 10.1017/s1481803500013063.Google ScholarGoogle ScholarCross RefCross Ref
  13. M. Sheraton, C. Gooch, and R. Kashyap, 'Patients leaving without being seen from the emergency department: A prediction model using machine learning on a nationwide database', JACEP, vol. 1, pp. 1684-1690, 2020, doi: 10.1002/emp2.12266.Google ScholarGoogle ScholarCross RefCross Ref
  14. T. A. Trunfio, A. Scala, A. D. Vecchia, A. Marra, and A. Borrelli, ‘Multiple Regression Model to Predict Length of Hospital Stay for Patients Undergoing Femur Fracture Surgery at “San Giovanni di Dio e Ruggi d'Aragona” University Hospital’, in 8th European Medical and Biological Engineering Conference, Cham, 2021, pp. 840–847, doi: 10.1007/978-3-030-64610-3_94.Google ScholarGoogle Scholar
  15. R. N. Mekhaldi, P. Caulier, S. Chaabane, A. Chraibi, and S. Piechowiak, ‘Using Machine Learning Models to Predict the Length of Stay in a Hospital Setting’, in Trends and Innovations in Information Systems and Technologies, Cham, 2020, pp. 202–211, doi: 10.1007/978-3-030-45688-7_21.Google ScholarGoogle ScholarCross RefCross Ref
  16. S. Bacchi, Y. Tan, L. Oakden‐Rayner, J. Jannes, T. Kleinig, and S. Koblar, ‘Machine Learning in the Prediction of Medical Inpatient Length of Stay’, Intern. Med. J., vol. n/a, no. n/a, doi: https://doi.org/10.1111/imj.14962.Google ScholarGoogle Scholar
  17. A. Scala, T. A. Trunfio, A. D. Vecchia, A. Marra, and A. Borrelli, ‘Lean Six Sigma Approach to Implement a Femur Fracture Care Pathway at “San Giovanni di Dio e Ruggi d'Aragona” University Hospital’, in 8th European Medical and Biological Engineering Conference, Cham, 2021, pp. 740–749, doi: 10.1007/978-3-030-64610-3_83.Google ScholarGoogle Scholar
  18. G. Improta, C. Ricciardi, A. Borrelli, A. D'alessandro, C. Verdoliva, and M. Cesarelli, ‘The application of six sigma to reduce the pre-operative length of hospital stay at the hospital Antonio Cardarelli’, Int. J. Lean Six Sigma, 2019, doi: 10.1108/IJLSS-02-2019-0014.Google ScholarGoogle ScholarCross RefCross Ref
  19. N. O. Foni , ‘Clinical pathway improves medical practice in total knee arthroplasty’, PLOS ONE, vol. 15, no. 5, p. e0232881, May 2020, doi: 10.1371/journal.pone.0232881.Google ScholarGoogle ScholarCross RefCross Ref
  20. Sheraton, M., Gooch, C., & Kashyap, R. (2020). Patients leaving without being seen from the emergency department: A prediction model using machine learning on a nationwide database. Journal of the American College of Emergency Physicians Open, 1(6), 1684-1690.Google ScholarGoogle Scholar
  21. T. Daghistani and R. Alshammari, ' Comparison of Statistical Logistic Regression and RandomForest Machine Learning Techniques in Predicting Diabetes', JAIT, vol. 11, no. 2, pp. 78-83, May 2020, doi: 10.12720/jait.11.2.78-83.Google ScholarGoogle ScholarCross RefCross Ref
  22. A. Burlacu , ‘Using Artificial Intelligence Resources in Dialysis and Kidney Transplant Patients: A Literature Review’, BioMed Res. Int., vol. 2020, p. e9867872, Jun. 2020, doi: 10.1155/2020/9867872.Google ScholarGoogle Scholar
  23. G. Improta , ‘Agile six sigma in healthcare: Case study at santobono pediatric hospital’, Int. J. Environ. Res. Public. Health, vol. 17, no. 3, 2020, doi: 10.3390/ijerph17031052.Google ScholarGoogle ScholarCross RefCross Ref
  24. C. Wang, X. Pan, L. Ye, W. Zhuang, and F. Ma, 'Forecast of Hospitalization Costs of Child Patients Based on Machine Learning Methods and Multiple Classification', JAIT, vol. 9, no. 4, pp. 89-96, Nov. 2018, doi: 10.12720/ jait.9.4.89-96Google ScholarGoogle ScholarCross RefCross Ref
  25. S.K. Polevoi, J.V. Quinn, N.R. Kramer, 'Factors associated with patients who leave without being seen', Acad. Emerg. Med., vol. 12, pp. 232–236, 2005, doi: 10.1197/j.aem.2004.10.029.Google ScholarGoogle ScholarCross RefCross Ref
  26. J. Crilly, N. Bost, L. Thalib, J. Timms, and H. Gleeson, 'Patients who present to the emergency department and leave without being seen: prevalence, predictors and outcomes', Eur. J. Emerg. Med. Off. J. Eur. Soc. Emerg. Med., vol 20, pp. 248-255, 2013, doi: 10.1097/MEJ.0b013e328356fa0e.Google ScholarGoogle ScholarCross RefCross Ref
  27. Ghafouri, S. M. M. S., & Haji, B. (2019, January). Utilizing a Simulation Approach for Analysis of Patient Flow in the Emergency Department: A Case Study. In 2019 15th Iran International Industrial Engineering Conference (IIIEC) (pp. 151-157). IEEE.Google ScholarGoogle ScholarCross RefCross Ref
  28. Vanbrabant, L., Braekers, K., Ramaekers, K., & Van Nieuwenhuyse, I. (2019). Simulation of emergency department operations: A comprehensive review of KPIs and operational improvements. Computers & Industrial Engineering, 131, 356-381.Google ScholarGoogle Scholar
  29. Nahhas, A., Awaldi, A., & Reggelin, T. (2017). Simulation and the emergency department overcrowding problem. Procedia Engineering, 178, 368-376.Google ScholarGoogle Scholar
  30. Fragapane, G. I., Zhang, C., Sgarbossa, F., & Strandhagen, J. O. (2019). An agent-based simulation approach to model hospital logistics. Int J Simul Model, 18(4), 654-665.Google ScholarGoogle Scholar
  31. Cesarelli, G., Scala, A., Vecchione, D., Ponsiglione, A. M., & Guizzi, G. (2021, February). An Innovative Business Model for a Multi-echelon Supply Chain Inventory Management Pattern. In Journal of Physics: Conference Series (Vol. 1828, No. 1, p. 012082). IOP Publishing.Google ScholarGoogle Scholar
  32. Ortíz-Barrios, M. A., & Alfaro-Saíz, J. J. (2020). Methodological approaches to support process improvement in emergency departments: a systematic review. International journal of environmental research and public health, 17(8), 2664.Google ScholarGoogle ScholarCross RefCross Ref
  33. Ponsiglione A M, Ricciardi C, Improta G, Orabona G D, Sorrentino A, Amato F and Romano M 2021 A Six Sigma DMAIC methodology as a support tool for Health Technology Assessment of two antibiotics Math. Biosci. Eng. 18 3469–90Google ScholarGoogle Scholar
  34. Improta, G., Guizzi, G., Ricciardi, C., Giordano, V., Ponsiglione, A.M., Converso, G., Triassi, M.: Agile Six Sigma in healthcare: Case study at santobono pediatric hospital. Int. J. Environ. Res. Public. Health. 17 (2020). https://doi.org/10.3390/ijerph17031052Google ScholarGoogle Scholar
  35. Han, J. H., France, D. J., Levin, S. R., Jones, I. D., Storrow, A. B., & Aronsky, D. (2010). The effect of physician triage on emergency department length of stay. The Journal of emergency medicine, 39(2), 227-233.Google ScholarGoogle Scholar
  36. Scala, A., Ponsiglione, A. M., Loperto, I., Della Vecchia, A., Borrelli, A., Russo, G., Triassi, M., & Improta, G. (2021). Lean six sigma approach for reducing length of hospital stay for patients with femur fracture in a university hospital. International Journal of Environmental Research and Public Health, 18(6), 2843.Google ScholarGoogle ScholarCross RefCross Ref
  37. Trunfio, T. A., Scala, A., Della Vecchia, A., Marra, A., & Borrelli, A. (2020, November). Multiple Regression Model to Predict Length of Hospital Stay for Patients Undergoing Femur Fracture Surgery at “San Giovanni di Dio e Ruggi d'Aragona” University Hospital. In European Medical and Biological Engineering Conference (pp. 840-847). Springer, Cham.Google ScholarGoogle Scholar
  38. Nayeri, N. D., & Aghajani, M. (2010). Patients’ privacy and satisfaction in the emergency department: a descriptive analytical study. Nursing ethics, 17(2), 167-177.Google ScholarGoogle Scholar
  39. Zohrevandi, B., & Tajik, H. (2014). A survey of patients' satisfaction in emergency department of Rasht Poursina Hospital. Emergency, 2(4), 162.Google ScholarGoogle Scholar
  40. Improta, G, Ponsiglione, A. M., Parente, G., Romano, M., Cesarelli, G., rea, T., Russo, M., Triassi, M.: Evaluation of Medical Training Courses Satisfaction: Qualitative Analysis and Analytic Hierarchy Process. In: Jarm T., Cvetkoska A., Mahnič-Kalamiza S., Miklavcic D. (eds) 8th European Medical and Biological Engineering Conference. EMBEC 2020. IFMBE Proceedings, vol 80. Springer, Cham. (2021)Google ScholarGoogle Scholar

Recommendations

Comments

Login options

Check if you have access through your login credentials or your institution to get full access on this article.

Sign in
  • Published in

    cover image ACM Other conferences
    ICBBS '21: Proceedings of the 2021 10th International Conference on Bioinformatics and Biomedical Science
    October 2021
    207 pages
    ISBN:9781450384308
    DOI:10.1145/3498731

    Copyright © 2021 ACM

    Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for components of this work owned by others than ACM must be honored. Abstracting with credit is permitted. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. Request permissions from [email protected]

    Publisher

    Association for Computing Machinery

    New York, NY, United States

    Publication History

    • Published: 26 January 2022

    Permissions

    Request permissions about this article.

    Request Permissions

    Check for updates

    Qualifiers

    • research-article
    • Research
    • Refereed limited

PDF Format

View or Download as a PDF file.

PDF

eReader

View online with eReader.

eReader

HTML Format

View this article in HTML Format .

View HTML Format