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Journal of general internal medicine

Optimizing Large Language Models for Hospital Discharge Prediction: A Retrospective Cohort Study with Inference-Time Optimization Strategies

In this retrospective cohort study at a single tertiary academic medical center, large language models predicted same-day discharge from clinical documentation in the 30 hours preceding a 06:00 index time for adult inpatients admitted in 2024 with a length of stay between 2 and 14 days, using a randomly generated validation set (n = 860) and test set (n = 886); the baseline GPT-5 prompt achieved an F1 score of 0.48 and sensitivity of 0.