Using Healthcare Resources Wisely: A Predictive Support System Regarding the Severity of Patient Falls

BACKGROUND: An injurious fall is one of the main indicators of care quality in healthcare facilities. Despite several fall screen tools being widely used to evaluate a patient's fall risk, they are frequently unable to reveal the severity level of patient falls. The purpose of this study is to build a practical system useful to predict the severity level of in-hospital falls. This practice is done in order to better allocate limited healthcare resources and to improve overall patient safety. METHODS: Four hundred and forty-six patients who experienced fall events at a large Taiwanese hospital were referenced. Eight predictors were used to ascertain the severity of patient falls solely based on the above study population. Multinomial logistic regression, Naïve Bayes, random forest, support vector machine, eXtreme gradient boosting, deep learning, and ensemble learning were adopted to establish predictive models. Accuracy, F1 score, precision, and recall were utilized to assess the models' performance. RESULTS: Compared to other learners, random forest exhibited satisfying predictive performance in terms of all metrics (accuracy: 0.844, F1 score: 0.850, precision: 0.839, and recall: 0.875 for the test dataset), and it was adopted as the base learner for a severity-level predictive system which is web-based. Furthermore, age, ability of independent activity, patient sources, use of assistive devices, and fall history within the past 12 months were deemed the top five important risk factors for evaluating fall severity. CONCLUSIONS: The application of machine learning techniques for predicting the severity level of patient falls may result in some benefits to monitor fall severity and to better allocate limited healthcare resources.