Abstract

Machine learning (ML) offers a wide range of techniques to predict medicine expenditures using historical expenditures data as well as other healthcare variables. For example, researchers have developed multilayer perceptron (MLP), long short-term memory (LSTM), and convolutional neural network (CNN) models for predicting healthcare outcomes. However, recently proposed generative approaches (e.g., generative adversarial networks; GANs) are yet to be explored for time-series prediction of medicine-related expenditures. The primary objective of this research was to develop and test a generative adversarial network model (called “variance-based GAN or V-GAN”) that specifically minimizes the difference in variance between model and actual data during model training. For our model development, we used patient expenditure data of a popular pain medication in the US. In the V-GAN model, we used an LSTM model as a generator network and a CNN model or an MLP model as a discriminator network. The V-GAN model's performance was compared with other GAN variants and ML models proposed in prior research such as linear regression (LR), gradient boosting regression (GBR), MLP, and LSTM. Results revealed that the V-GAN model using an LSTM generator and a CNN discriminator outperformed other GAN-based prediction models, as well as the LR, GBR, MLP, and LSTM models in correctly predicting medicine expenditures of patients. Through this research, we highlight the utility of developing GAN-based architectures involving variance minimization for predicting patient-related expenditures in the healthcare domain.

Highlights

  • According to the Centers for Medicare and Medicaid Services, the National Health Expenditure in the United States reached $3.2 trillion in 2015, which makes it $9,990 per person per year [1]

  • We have reported two quantities: 1) the root mean square error (RMSE) on training and test data; and, 2) the percentage of real-like samples reported by the discriminator model for different generative adversarial network (GAN) models

  • We experimented with different combinations of loss functions to train the generator and discriminator models in a GAN and proposed a novel variance-based GAN (V-GAN) architecture, which minimized the difference in variance between model and actual data explicitly

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Summary

Introduction

According to the Centers for Medicare and Medicaid Services, the National Health Expenditure in the United States reached $3.2 trillion in 2015, which makes it $9,990 per person per year [1]. Such huge expenditures on healthcare may not lead to affordable healthcare to patients [2]. It is crucial to predict the likely future patient-related expenditures to help patients better manage their huge healthcare costs. Developing accurate healthcare expenditure models may help patients to choose appropriate insurance plans and may help healthcare delivery systems in better business planning [3].

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