Machine Learning-Based Early Prediction of Hospital Readmission Risk Among Chronic Disease Patients Using Electronic Health Records: A Comparative Study of Ensemble Learning Models
Md Yassir Mottalib , Master of Science in Information System Technology, Wilmington University, USA Eklachur Rahman Bhuiyan , Master of Science in Information Technology, Washington University of Science and Technology, USA Anwar Hossain , Master of Public Health, St.Francis College, NY, USA Md. Rashed Islam , Master of Healthcare Management, St. Francis College, Brooklyn, New York, USA Dahika Alam Nimu , MBBS, Dinajpur Medical College, Bangladesh MD IMRAN HASAN TUHIN , Master's in Information Technology, St.Francis College, NY, USA Mohammad Nasir Uddin , Masters of Business Administration, Major in Data Analytics, Westcliff University, USA. Ali Asgher Raju , Master’s in Biomedical Engineering, Gannon University, Erie, PA, USA
Articles
| Open Access
Abstract
Hospital readmission among patients with chronic diseases remains a major challenge for healthcare systems due to its association with poor patient outcomes and increased healthcare costs. This study proposes a machine learning-based framework for the early prediction of 30-day hospital readmission risk using the publicly available Diabetes 130-US Hospitals dataset from the UCI Machine Learning Repository. A comprehensive preprocessing pipeline, feature engineering, and feature selection techniques were employed to improve data quality and predictive performance. Eight supervised machine learning algorithms, including Logistic Regression, Decision Tree, Random Forest, Support Vector Machine, LightGBM, CatBoost, Multilayer Perceptron, and XGBoost, were developed and comparatively evaluated. Model performance was assessed using accuracy, precision, recall, F1-score, specificity, and the area under the receiver operating characteristic curve (AUC-ROC). The experimental results demonstrated that ensemble learning models consistently outperformed conventional machine learning approaches. Among all evaluated models, XGBoost achieved the best performance, attaining 92.16% accuracy, 0.92 precision, 0.91 recall, 0.91 F1-score, 0.95 specificity, and an AUC-ROC of 0.972. These findings indicate that XGBoost effectively identifies patients at high risk of early hospital readmission and can serve as a reliable predictive tool for clinical decision support. The proposed framework has strong potential for integration with Electronic Health Record systems to facilitate early intervention, improve patient outcomes, reduce preventable readmissions, and support value-based healthcare delivery.
Keywords
Hospital Readmission Prediction, Machine Learning, Chronic Disease, Electronic Health Records (EHR), XGBoost, Ensemble Learning, Clinical Decision Support System (CDSS), Predictive Analytics, Healthcare Artificial Intelligence, Readmission Risk Assessment
References
Dua, D., & Graff, C. (2019). Diabetes 130-US hospitals for years 1999–2008 data set. UCI Machine Learning Repository. https://archive.ics.uci.edu/dataset/296/diabetes+130-us+hospitals+for+years+1999-2008
Strack, B., DeShazo, J. P., Gennings, C., Olmo, J. L., Ventura, S., Cios, K. J., & Clore, J. N. (2014). Impact of HbA1c measurement on hospital readmission rates: Analysis of 70,000 clinical database patient records. BioMed Research International, 2014, Article 781670. https://doi.org/10.1155/2014/781670
Dua, D., & Graff, C. (2019). UCI Machine Learning Repository. University of California, Irvine, School of Information and Computer Sciences. https://archive.ics.uci.edu/ml
Agency for Healthcare Research and Quality. (2023). National Healthcare Quality and Disparities Report. https://www.ahrq.gov/research/findings/nhqrdr/index.html
Centers for Medicare & Medicaid Services. (2024). Hospital Readmissions Reduction Program (HRRP). https://www.cms.gov/medicare/quality/hospital-readmissions-reduction-program
Chen, T., & Guestrin, C. (2016). XGBoost: A scalable tree boosting system. Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining, 785–794. https://doi.org/10.1145/2939672.2939785
Ke, G., Meng, Q., Finley, T., Wang, T., Chen, W., Ma, W., Ye, Q., & Liu, T. Y. (2017). LightGBM: A highly efficient gradient boosting decision tree. Advances in Neural Information Processing Systems, 30, 3146–3154.
Lundberg, S. M., Erion, G., Chen, H., DeGrave, A., Prutkin, J. M., Nair, B., Katz, R., Himmelfarb, J., Bansal, N., & Lee, S. I. (2020). From local explanations to global understanding with explainable AI for trees. Nature Machine Intelligence, 2(1), 56–67. https://doi.org/10.1038/s42256-019-0138-9
Prokhorenkova, L., Gusev, G., Vorobev, A., Dorogush, A. V., & Gulin, A. (2018). CatBoost: Unbiased boosting with categorical features. Advances in Neural Information Processing Systems, 31, 6638–6648.
Shickel, B., Tighe, P. J., Bihorac, A., & Rashidi, P. (2018). Deep EHR: A survey of recent advances in deep learning techniques for electronic health record analysis. IEEE Journal of Biomedical and Health Informatics, 22(5), 1589–1604. https://doi.org/10.1109/JBHI.2017.2767063
World Health Organization. (2023). Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
Breiman, L. (2001). Random forests. Machine Learning, 45(1), 5–32. https://doi.org/10.1023/A:1010933404324
Cortes, C., & Vapnik, V. (1995). Support-vector networks. Machine Learning, 20(3), 273–297. https://doi.org/10.1007/BF00994018
Strack, B., DeShazo, J. P., Gennings, C., Olmo, J. L., Ventura, S., Cios, K. J., & Clore, J. N. (2014). Impact of HbA1c measurement on hospital readmission rates: Analysis of 70,000 clinical database patient records. BioMed Research International, 2014, Article 781670. https://doi.org/10.1155/2014/781670
Article Statistics
Downloads
Copyright License
Copyright (c) 2026 Md Yassir Mottalib, Eklachur Rahman Bhuiyan, Anwar Hossain, Md. Rashed Islam, Dahika Alam Nimu, MD IMRAN HASAN TUHIN, Mohammad Nasir Uddin, Ali Asgher Raju

This work is licensed under a Creative Commons Attribution 4.0 International License.