Background. Hospital readmission prediction in pediatric hospitals has received little attention. Studies have focused on the readmission frequency analysis stratified by disease and demographic/geographic characteristics but there are no predictive modeling approaches, which may be useful to identify preventable readmissions that constitute a major portion of the cost attributed to readmissions.Objective. To assess the all-cause readmission predictive performance achieved by machine learning techniques in the emergency department of a pediatric hospital in Santiago, Chile.Materials. An all-cause admissions dataset has been collected along six consecutive years in a pediatric hospital in Santiago, Chile. The variables collected are the same used for the determination of the child’s treatment administrative cost.Methods. Retrospective predictive analysis of 30-day readmission was formulated as a binary classification problem. We report classification results achieved with various model building approaches after data curation and preprocessing for correction of class imbalance. We compute repeated cross-validation (RCV) with decreasing number of folders to assess performance and sensitivity to effect of imbalance in the test set and training set size.Results. Increase in recall due to SMOTE class imbalance correction is large and statistically significant. The Naive Bayes (NB) approach achieves the best AUC (0.65); however the shallow multilayer perceptron has the best PPV and f-score (5.6 and 10.2, resp.). The NB and support vector machines (SVM) give comparable results if we consider AUC, PPV, and f-score ranking for all RCV experiments. High recall of deep multilayer perceptron is due to high false positive ratio. There is no detectable effect of the number of folds in the RCV on the predictive performance of the algorithms.Conclusions. We recommend the use of Naive Bayes (NB) with Gaussian distribution model as the most robust modeling approach for pediatric readmission prediction, achieving the best results across all training dataset sizes. The results show that the approach could be applied to detect preventable readmissions.

The need of having a more preventive, personalized and anticipatory healthcare for chronically ill patients entails a continuous provisioning of health services everywhere, anytime and to anyone. The ubiquitous computing paradigm is an approach to realize this vision. Nevertheless, the use of all potential ubiquitous health services and contextual information is quite limited in the literature. To tackle this issue, this paper proposes a semantic framework for continuous ubiquitous services provisioning. Patients needs are represented in business processes. Also, this paper proposes a semantic description model of processes, services, as well as medical and environmental contextual information, in order to make it easier to select appropriate services out of semantically selected business processes. The suitability of the framework is evaluated through a case study for respiratory chronic disease, by making use of real patient data and health professionals from a public pediatric hospital