Heterogeneous readmission prediction with hierarchical effect decomposition and regularization

Fuente: arXiv
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Autores principales: Jiang, Ziren, Huo, Lingfeng, Hou, Jue, Vaughan-Sarrazin, Mary, Smith, Maureen A., Huling, Jared D.
Formato: Preprint
Publicado: 2026
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author Jiang, Ziren
Huo, Lingfeng
Hou, Jue
Vaughan-Sarrazin, Mary
Smith, Maureen A.
Huling, Jared D.
author_facet Jiang, Ziren
Huo, Lingfeng
Hou, Jue
Vaughan-Sarrazin, Mary
Smith, Maureen A.
Huling, Jared D.
contents Accurately predicting hospital readmission risks using electronic health records (EHRs) is critical for effective patient management and healthcare resource allocation. Patient populations in health systems are highly heterogeneous across different primary diagnoses, necessitating tailored yet interpretable prediction models. We propose a hierarchical modeling framework incorporating hierarchical nested re-parameterization and structured regularization methods, which we call hierNest. Specifically, our approach leverages the inherent hierarchical structure present in primary diagnoses and groupings of these diagnoses into major diagnostic categories. Our methodology facilitates information borrowing across related patient subgroups and preserves interpretability at different hierarchical levels. Simulation studies demonstrate superior predictive accuracy of the proposed method, particularly with small subgroup sample sizes and varying degrees of hierarchical effects. We apply our methods to a large EHR dataset comprising Medicare patients.
format Preprint
id arxiv_https___arxiv_org_abs_2603_19569
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Heterogeneous readmission prediction with hierarchical effect decomposition and regularization
Jiang, Ziren
Huo, Lingfeng
Hou, Jue
Vaughan-Sarrazin, Mary
Smith, Maureen A.
Huling, Jared D.
Methodology
Accurately predicting hospital readmission risks using electronic health records (EHRs) is critical for effective patient management and healthcare resource allocation. Patient populations in health systems are highly heterogeneous across different primary diagnoses, necessitating tailored yet interpretable prediction models. We propose a hierarchical modeling framework incorporating hierarchical nested re-parameterization and structured regularization methods, which we call hierNest. Specifically, our approach leverages the inherent hierarchical structure present in primary diagnoses and groupings of these diagnoses into major diagnostic categories. Our methodology facilitates information borrowing across related patient subgroups and preserves interpretability at different hierarchical levels. Simulation studies demonstrate superior predictive accuracy of the proposed method, particularly with small subgroup sample sizes and varying degrees of hierarchical effects. We apply our methods to a large EHR dataset comprising Medicare patients.
title Heterogeneous readmission prediction with hierarchical effect decomposition and regularization
topic Methodology
url https://arxiv.org/abs/2603.19569