Interpretable (not just posthoc-explainable) medical claims modeling for discharge placement to reduce preventable all-cause readmissions or death

PLoS One. 2024 May 9;19(5):e0302871. doi: 10.1371/journal.pone.0302871. eCollection 2024.

Abstract

We developed an inherently interpretable multilevel Bayesian framework for representing variation in regression coefficients that mimics the piecewise linearity of ReLU-activated deep neural networks. We used the framework to formulate a survival model for using medical claims to predict hospital readmission and death that focuses on discharge placement, adjusting for confounding in estimating causal local average treatment effects. We trained the model on a 5% sample of Medicare beneficiaries from 2008 and 2011, based on their 2009-2011 inpatient episodes (approximately 1.2 million), and then tested the model on 2012 episodes (approximately 400 thousand). The model scored an out-of-sample AUROC of approximately 0.75 on predicting all-cause readmissions-defined using official Centers for Medicare and Medicaid Services (CMS) methodology-or death within 30-days of discharge, being competitive against XGBoost and a Bayesian deep neural network, demonstrating that one need-not sacrifice interpretability for accuracy. Crucially, as a regression model, it provides what blackboxes cannot-its exact gold-standard global interpretation, explicitly defining how the model performs its internal "reasoning" for mapping the input data features to predictions. In doing so, we identify relative risk factors and quantify the effect of discharge placement. We also show that the posthoc explainer SHAP provides explanations that are inconsistent with the ground truth model reasoning that our model readily admits.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bayes Theorem*
  • Female
  • Humans
  • Male
  • Medicare*
  • Neural Networks, Computer
  • Patient Discharge* / statistics & numerical data
  • Patient Readmission* / statistics & numerical data
  • United States / epidemiology

Grants and funding

CCC is supported by the Intramural Research Program of the NIH, NIDDK. JCC is partially supported by the Intramural Research Program of the NIH, Clinical Center. This work used the Extreme Science and Engineering Discovery Environment (XSEDE) [58], which is supported by National Science Foundation grant number ACI-1548562 through allocation TG-DMS190042.