A metaheuristic-based stacking model for predicting the risk of patient no-show and late cancellation for neurology appointments

Abstract

Patient no-shows and late cancellations for an appointment are common problems in healthcare, which adversely affect the financial performance and quality of service of healthcare organizations. A high rate of patient no-show and late cancellation in a clinic can significantly limit access to healthcare. In general, hospitals create predictive models to assess risk of no-show, and then assign overbooking appointments utilizing those risks. In this paper, by incorporating machine learning and optimization techniques, we proposed a predictive model to assist with the overbooking decision. The model consists of two phases. First, we utilized a metaheuristic optimization technique to explore the best subset of features — known as feature selection problem — that can significantly contribute to the prediction outcomes. Second, using the output of the first stage, we proposed a stacking model to improve the prediction performances further. Our extensive computations and comparisons across different classifiers show that formulating the feature selection problem as a multi-objective problem instead of a single-objective problem using random forest classifier yields better results. The proposed model will improve the overbooking at clinics, by increasing the patient access to care. We introduced important new features to the literature that can describe the no-show and late cancellation behavior.