Long-term care plan recommendation for older adults with disabilities: a bipartite graph transformer and self-supervised approach

Abstract Background With the global population aging and advancements in the medical system, long-term care in healthcare institutions and home settings has become essential for older adults with disabilities. However, the diverse and scattered care requirements of these individuals make developing effective long-term care plans heavily reliant on professional nursing staff, and even experienced caregivers may make mistakes or face confusion during the care plan development process. Consequently, there is a rigid demand for intelligent systems that can recommend comprehensive long-term care plans for older adults with disabilities who have stable clinical conditions. Objective This study aims to utilize deep learning methods to recommend comprehensive care plans for the older adults with disabilities. Methods We model the care data of older adults with disabilities using a bipartite graph. Additionally, we employ a prediction-based graph self-supervised learning (SSL) method to mine deep representations of graph nodes. Furthermore, we propose a novel graph Transformer architecture that incorporates eigenvector centrality to augment node features and uses graph structural information as references for the self-attention mechanism. Ultimately, we present the Bipartite Graph Transformer (BiT) model to provide personalized long-term care plan recommendation. Results We constructed a bipartite graph comprising of 1917 nodes and 195 240 edges derived from real-world care data. The proposed model demonstrates outstanding performance, achieving an overall F1 score of 0.905 for care plan recommendations. Each care service item reached an average F1 score of 0.897, indicating that the BiT model is capable of accurately selecting services and effectively balancing the trade-off between incorrect and missed selections. Discussion The BiT model proposed in this paper demonstrates strong potential for improving long-term care plan recommendations by leveraging bipartite graph modeling and graph SSL. This approach addresses the challenges of manual care planning, such as inefficiency, bias, and errors, by offering personalized and data-driven recommendations. While the model excels in common care items, its performance on rare or complex services could be enhanced with further refinement. These findings highlight the model's ability to provide scalable, AI-driven solutions to optimize care planning, though future research should explore its applicability across diverse healthcare settings and service types. Conclusions Compared to previous research, the novel model proposed in this article effectively learns latent topology in bipartite graphs and achieves superior recommendation performance. Our study demonstrates the applicability of SSL and graph transformers in recommending long-term care plans for older adults with disabilities.