Context-Aware Hospitalization Forecasting Evaluations for Decision Support using LLMs
Medical and public health experts must make real-time resource decisions, such as expanding hospital bed capacity, based on projected hospitalization trends during large-scale healthcare disruptions (e.g., operational failures or pandemics). Forecasting models can assist in this task by analyzing large volumes of resource-related data at the facility level, but they must be reliable for decision-making under real-world data conditions. Recent work shows that large language models (LLMs) can incorporate richer forms of context into numerical forecasting. Whereas traditional models rely primarily on temporal context (i.e., past observations), LLMs can also leverage non-temporal public health context such as demographic, geographic, and population-level features. However, it remains unclear how these models should be used to produce stable or decision-relevant predictions in real-world healthcare settings. To evaluate how LLMs can be effectively used in this setting, we evaluate three approaches across 60 counties with low-,mid-, and high-hospitalization intensities in the United States: direct LLM-based forecasting, classical time-series models, and a context-augmented hybrid pipeline (HybridARX) that incorporates LLM-derived signals into structured models. Because the goal is operational decision-making rather than error minimization alone, we evaluate performance with bias and lead-lag alignment in addition to standard forecasting metrics. Our results show that HybridARX improves over classical ARX by yielding more stable and better-calibrated forecasts, particularly when incorporating noisy contextual signals into structured time-series models. These findings suggest that, in non-stationary healthcare resource forecasting, LLMs are most useful when embedded within structured hybrid models.
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Computer Science > Artificial Intelligence arXiv:2604.23949 (cs) [Submitted on 27 Apr 2026] Title:Context-Aware Hospitalization Forecasting Evaluations for Decision Support using LLMs Authors:Rhea Makkuni, Ananya Joshi View a PDF of the paper titled Context-Aware Hospitalization Forecasting Evaluations for Decision Support using LLMs, by Rhea Makkuni and 1 other authors View PDF HTML (experimental) Abstract:Medical and public health experts must make real-time resource decisions, such as expanding hospital bed capacity, based on projected hospitalization trends during large-scale healthcare disruptions (e.g., operational failures or pandemics). Forecasting models can assist in this task by analyzing large volumes of resource-related data at the facility level, but they must be reliable for decision-making under real-world data conditions. Recent work shows that large language models (LLMs) can incorporate richer forms of context into numerical forecasting. Whereas traditional models rely primarily on temporal context (i.e., past observations), LLMs can also leverage non-temporal public health context such as demographic, geographic, and population-level features. However, it remains unclear how these models should be used to produce stable or decision-relevant predictions in real-world healthcare settings. To evaluate how LLMs can be effectively used in this setting, we evaluate three approaches across 60 counties with low-,mid-, and high-hospitalization intensities in the United States: direct LLM-based forecasting, classical time-series models, and a context-augmented hybrid pipeline (HybridARX) that incorporates LLM-derived signals into structured models. Because the goal is operational decision-making rather than error minimization alone, we evaluate performance with bias and lead-lag alignment in addition to standard forecasting metrics. Our results show that HybridARX improves over classical ARX by yielding more stable and better-calibrated forecasts, particularly when incorporating noisy contextual signals into structured time-series models. These findings suggest that, in non-stationary healthcare resource forecasting, LLMs are most useful when embedded within structured hybrid models. Subjects: Artificial Intelligence (cs.AI) Cite as: arXiv:2604.23949 [cs.AI] (or arXiv:2604.23949v1 [cs.AI] for this version) https://doi.org/10.48550/arXiv.2604.23949 Focus to learn more arXiv-issued DOI via DataCite (pending registration) Submission history From: Ananya Joshi [view email] [v1] Mon, 27 Apr 2026 01:56:55 UTC (428 KB) Full-text links: Access Paper: View a PDF of the paper titled Context-Aware Hospitalization Forecasting Evaluations for Decision Support using LLMs, by Rhea Makkuni and 1 other authorsView PDFHTML (experimental)TeX Source view license Current browse context: cs.AI < prev | next > new | recent | 2026-04 Change to browse by: cs References & Citations NASA ADSGoogle Scholar Semantic Scholar export BibTeX citation Loading... BibTeX formatted citation × loading... Data provided by: Bookmark Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer (What is the Explorer?) Connected Papers Toggle Connected Papers (What is Connected Papers?) Litmaps Toggle Litmaps (What is Litmaps?) scite.ai Toggle scite Smart Citations (What are Smart Citations?) Code, Data, Media Code, Data and Media Associated with this Article alphaXiv Toggle alphaXiv (What is alphaXiv?) Links to Code Toggle…
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