Sascha Kwakernaak1, Kasper van Mens2, Wiepke Cahn3, Richard Janssen4. 1. Altrecht Mental Health Care; Tilburg University, Department of Tranzo Scientific Center for Care and Welfare, The Netherlands. Electronic address: s.kwakernaak@uvt.nl. 2. Altrecht Mental Health Care; Trimbos Institute, the Netherlands. 3. Altrecht Mental Health Care; University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience. 4. Tilburg University, Department of Tranzo Scientific Center for Care and Welfare, The Netherlands; Erasmus University Rotterdam, Department of Health Care Governance.
Abstract
OBJECTIVE: The main goal of the study was to predict individual patients' future mental healthcare consumption, and thereby enhancing the design of an efficient demand-oriented mental healthcare system by focusing on a patient population associated with intensive mental healthcare consumption. Factors that affect the mental healthcare consumption of service users with non-affective psychosis were identified, and subsequently used in a prognostic model to predict future healthcare consumption. METHOD: This study was a secondary analysis of an existing dataset from the GROUP study. Based on mental healthcare consumption, patients with non-affective psychosis were divided into two groups: low (N = 579) and high (N = 488) intensive mental healthcare consumers. Three different techniques from the field of machine learning were applied on crosssectional data to identify risk factors: logistic regression, classification tree and a random forest. Subsequently, the same techniques were applied longitudinally in order to predict future healthcare consumption. RESULTS: Identified variables that affected healthcare consumption were the number of psychotic episodes, paid employment, engagement in social activities, previous healthcare consumption, and met needs. Analyses showed that the random forest method is best suited to model risk factors, and that these relations predict future healthcare consumption (AUC 0.71, PPV 0.65). CONCLUSIONS: Machine learning techniques provide valuable information for identifying risk factors in psychosis. They may thus help clinicians optimize allocation of mental healthcare resources by predicting future healthcare consumption.
OBJECTIVE: The main goal of the study was to predict individual patients' future mental healthcare consumption, and thereby enhancing the design of an efficient demand-oriented mental healthcare system by focusing on a patient population associated with intensive mental healthcare consumption. Factors that affect the mental healthcare consumption of service users with non-affective psychosis were identified, and subsequently used in a prognostic model to predict future healthcare consumption. METHOD: This study was a secondary analysis of an existing dataset from the GROUP study. Based on mental healthcare consumption, patients with non-affective psychosis were divided into two groups: low (N = 579) and high (N = 488) intensive mental healthcare consumers. Three different techniques from the field of machine learning were applied on crosssectional data to identify risk factors: logistic regression, classification tree and a random forest. Subsequently, the same techniques were applied longitudinally in order to predict future healthcare consumption. RESULTS: Identified variables that affected healthcare consumption were the number of psychotic episodes, paid employment, engagement in social activities, previous healthcare consumption, and met needs. Analyses showed that the random forest method is best suited to model risk factors, and that these relations predict future healthcare consumption (AUC 0.71, PPV 0.65). CONCLUSIONS: Machine learning techniques provide valuable information for identifying risk factors in psychosis. They may thus help clinicians optimize allocation of mental healthcare resources by predicting future healthcare consumption.