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Identification of hospital cost drivers using sparse group lasso.

ABSTRACT: Public hospital spending consumes a large share of government expenditure in many countries. The large cost variability observed between hospitals and also between patients in the same hospital has fueled the belief that consumption of a significant portion of this funding may result in no clinical benefit to patients, thus representing waste. Accurate identification of the main hospital cost drivers and relating them quantitatively to the observed cost variability is a necessary step towards identifying and reducing waste. This study identifies prime cost drivers in a typical, mid-sized Australian hospital and classifies them as sources of cost variability that are either warranted or not warranted-and therefore contributing to waste. An essential step is dimension reduction using Principal Component Analysis to pre-process the data by separating out the low value 'noise' from otherwise valuable information. Crucially, the study then adjusts for possible co-linearity of different cost drivers by the use of the sparse group lasso technique. This ensures reliability of the findings and represents a novel and powerful approach to analysing hospital costs. Our statistical model included 32 potential cost predictors with a sample size of over 50,000 hospital admissions. The proportion of cost variability potentially not clinically warranted was estimated at 33.7%. Given the financial footprint involved, once the findings are extrapolated nationwide, this estimation has far-reaching significance for health funding policy.

SUBMITTER: Swierkowski P

PROVIDER: S-EPMC6179217 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Identification of hospital cost drivers using sparse group lasso.

Swierkowski Piotr P Barnett Adrian A

PloS one 20181010 10

Public hospital spending consumes a large share of government expenditure in many countries. The large cost variability observed between hospitals and also between patients in the same hospital has fueled the belief that consumption of a significant portion of this funding may result in no clinical benefit to patients, thus representing waste. Accurate identification of the main hospital cost drivers and relating them quantitatively to the observed cost variability is a necessary step towards id ...[more]

PMID: 30303977

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Project description:Recent works have shown that the resting-state brain functional connectivity hypernetwork, where multiple nodes can be connected, are an effective technique for brain disease diagnosis and classification research. The lasso method was used to construct hypernetworks by solving sparse linear regression models in previous research. But, constructing a hypernetwork based on the lasso method simply selects a single variable, in that it lacks the ability to interpret the grouping effect. Considering the group structure problem, the previous study proposed to create a hypernetwork based on the elastic net and the group lasso methods, and the results showed that the former method had the best classification performance. However, the highly correlated variables selected by the elastic net method were not necessarily in the active set in the group. Therefore, we extended our research to address this issue. Herein, we propose a new method that introduces the sparse group lasso method to improve the construction of the hypernetwork by solving the group structure problem of the brain regions. We used the traditional lasso, group lasso method, and sparse group lasso method to construct a hypernetwork in patients with depression and normal subjects. Meanwhile, other clustering coefficients (clustering coefficients based on pairs of nodes) were also introduced to extract features with traditional clustering coefficients. Two types of features with significant differences obtained after feature selection were subjected to multi-kernel learning for feature fusion and classification using each method, respectively. The network topology results revealed differences among the three networks, where hypernetwork using the lasso method was the strictest; the group lasso, most lenient; and the sgLasso method, moderate. The network topology of the sparse group lasso method was similar to that of the group lasso method but different from the lasso method. The classification results show that the sparse group lasso method achieves the best classification accuracy by using multi-kernel learning, which indicates that better classification performance can be achieved when the group structure exists and is properly extended.

Dataset Information

Identification of hospital cost drivers using sparse group lasso.

Publications

Identification of hospital cost drivers using sparse group lasso.

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