Demand prediction of medical services in home and community-based services for older adults in China using machine learning

Frontiers in Public Health

Public Health

Xiangyang Zhang¹  Huajian Chen¹  Yucheng Huang¹  Tingke Xu¹  Qingren Yang¹  Lu Zhan¹  Chun Chen²  Chengxi Pan³ 

[1] School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China;School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China;Center for Healthy China Research, Wenzhou Medical University, Wenzhou, Zhejiang, China;The State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Signaling Network, School of Life Sciences, Xiamen University, Xiamen, China;

关键词: home and community-based services;    Andersen's behavioral model;    Chinese Longitudinal Healthy Longevity Survey;    demand prediction model;    machine learning;   

DOI  :  10.3389/fpubh.2023.1142794

 received in 2023-01-12, accepted in 2023-02-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundHome and community-based services are considered an appropriate and crucial caring method for older adults in China. However, the research examining demand for medical services in HCBS through machine learning techniques and national representative data has not yet been carried out. This study aimed to address the absence of a complete and unified demand assessment system for home and community-based services.MethodsThis was a cross-sectional study conducted on 15,312 older adults based on the Chinese Longitudinal Healthy Longevity Survey 2018. Models predicting demand were constructed using five machine-learning methods: Logistic regression, Logistic regression with LASSO regularization, Support Vector Machine, Random Forest, and Extreme Gradient Boosting (XGboost), and based on Andersen's behavioral model of health services use. Methods utilized 60% of older adults to develop the model, 20% of the samples to examine the performance of models, and the remaining 20% of cases to evaluate the robustness of the models. To investigate demand for medical services in HCBS, individual characteristics such as predisposing, enabling, need, and behavior factors constituted four combinations to determine the best model.ResultsRandom Forest and XGboost models produced the best results, in which both models were over 80% at specificity and produced robust results in the validation set. Andersen's behavioral model allowed for combining odds ratio and estimating the contribution of each variable of Random Forest and XGboost models. The three most critical features that affected older adults required medical services in HCBS were self-rated health, exercise, and education.ConclusionAndersen's behavioral model combined with machine learning techniques successfully constructed a model with reasonable predictors to predict older adults who may have a higher demand for medical services in HCBS. Furthermore, the model captured their critical characteristics. This method predicting demands could be valuable for the community and managers in arranging limited primary medical resources to promote healthy aging.

【 授权许可】

Unknown   
Copyright © 2023 Huang, Xu, Yang, Pan, Zhan, Chen, Zhang and Chen.