Predicting the inpatient hospital cost using a machine learning approach

Abstract

Purpose

Increasing health-care costs are a major concern, especially in the USA. The purpose of this paper is to predict the hospital charges of a patient before being admitted. This will help a patient who is getting admitted: “electively” can plan his/her finance. Also, this can be used as a tool by payers (insurance companies) to better forecast the amount that a patient might claim.

Design/methodology/approach

This research method involves secondary data collected from New York state’s patient discharges of 2017. A stratified sampling technique is used to sample the data from the population, feature engineering is done on categorical variables. Different regression techniques are being used to predict the target value “total charges.”

Findings

Total cost varies linearly with the length of stay. Among all the machine learning algorithms considered, namely, random forest, stochastic gradient descent (SGD) regressor, K nearest neighbors regressor, extreme gradient boosting regressor and gradient boosting regressor, random forest regressor had the best accuracy with R² value 0.7753. “Age group” was the most important predictor among all the features.

Practical implications

This model can be helpful for patients who want to compare the cost at different hospitals and can plan their finances accordingly in case of “elective” admission. Insurance companies can predict how much a patient with a particular medical condition might claim by getting admitted to the hospital.

Originality/value

Health care can be a costly affair if not planned properly. This research gives patients and insurance companies a better prediction of the total cost that they might incur.

Citation

Kulkarni, S., Ambekar, S.S. and Hudnurkar, M. (2021), "Predicting the inpatient hospital cost using a machine learning approach", International Journal of Innovation Science, Vol. 13 No. 1, pp. 87-104. https://doi.org/10.1108/IJIS-09-2020-0175