Predicting waiting time to treatment for emergency department patients

Pak, Anton, Gannon, Brenda, and Staib, Andrew (2021) Predicting waiting time to treatment for emergency department patients. International Journal of Medical Informatics, 145. 104303.

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Abstract

Background

The current systems of reporting waiting time to patients in public emergency departments (EDs) has largely relied on rolling average or median estimators which have limited accuracy. This study proposes to use machine learning (ML) algorithms that significantly improve waiting time forecasts.

Methods

By implementing ML algorithms and using a large set of queueing and service flow variables, we provide evidence of the improvement in waiting time predictions for low acuity ED patients assigned to the waiting room. In addition to the mean squared prediction error (MSPE) and mean absolute prediction error (MAPE), we advocate to use the percentage of underpredicted observations. The use of ML algorithms is motivated by their advantages in exploring data connections in flexible ways, identifying relevant predictors, and preventing overfitting of the data. We also use quantile regression to generate time forecasts which may better address the patient’s asymmetric perception of underpredicted and overpredicted ED waiting times.

Results

Using queueing and service flow variables together with information on diurnal fluctuations, ML models outperform the best rolling average by over 20% with respect to MSPE and quantile regression reduces the number of patients with large underpredicted waiting times by 42%.

Conclusion

We find robust evidence that the proposed estimators generate more accurate ED waiting time predictions than the rolling average. We also show that to increase the predictive accuracy further, a hospital ED may decide to provide predictions to patients registered only during the daytime when the ED operates at full capacity, thus translating to more predictive service rates and the demand for treatments.

Item ID: 65500
Item Type: Article (Research - C1)
ISSN: 1872-8243
Keywords: Waiting time, Health service, Operations management
Copyright Information: © 2020 Elsevier B.V. All rights reserved.
Funders: Australian Government (AG)
Projects and Grants: AG Research Training Program (RTP) Scholarship
Date Deposited: 13 Jan 2021 05:14
FoR Codes: 38 ECONOMICS > 3802 Econometrics > 380203 Economic models and forecasting @ 50%
46 INFORMATION AND COMPUTING SCIENCES > 4602 Artificial intelligence > 460207 Modelling and simulation @ 30%
38 ECONOMICS > 3801 Applied economics > 380108 Health economics @ 20%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920206 Health Policy Economic Outcomes @ 50%
97 EXPANDING KNOWLEDGE > 970114 Expanding Knowledge in Economics @ 50%
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