Effective Predictive Modeling for Emergency Department Visits and Evaluating Exogenous Variables Impact: Using Explainable Meta-learning Gradient Boosting

Over an extensive duration, administrators and clinicians have endeavoured to predict Emergency Department (ED) visits with precision, aiming to optimise resource distribution. Despite the proliferation of diverse AI-driven models tailored for precise prognostication, this task persists as a formidable challenge, besieged by constraints such as restrained generalisability, susceptibility to overfitting and underfitting, scalability issues, and complex fine-tuning hyper-parameters. In this study, we introduce a novel Meta-learning Gradient Booster (Meta-ED) approach for precisely forecasting daily ED visits and leveraging a comprehensive dataset of exogenous variables, including socio-demographic characteristics, healthcare service use, chronic diseases, diagnosis, and climate parameters spanning 23 years from Canberra Hospital in ACT, Australia. The proposed Meta-ED consists of four foundational learners-Catboost, Random Forest, Extra Tree, and lightGBoost-alongside a dependable top-level learner, Multi-Layer Perceptron (MLP), by combining the unique capabilities of varied base models (sub-learners). Our study assesses the efficacy of the Meta-ED model through an extensive comparative analysis involving 23 models. The evaluation outcomes reveal a notable superiority of Meta-ED over the other models in accuracy at 85.7% (95% CI ;85.4%, 86.0%) and across a spectrum of 10 evaluation metrics. Notably, when compared with prominent techniques, XGBoost, Random Forest (RF), AdaBoost, LightGBoost, and Extra Tree (ExT), Meta-ED showcases substantial accuracy enhancements of 58.6%, 106.3%, 22.3%, 7.0%, and 15.7%, respectively. Furthermore, incorporating weather-related features demonstrates a 3.25% improvement in the prediction accuracy of visitors' numbers. The encouraging outcomes of our study underscore Meta-ED as a foundation model for the precise prediction of daily ED visitors.