Modelling Hospital Admission and Length of Stay by Means of Generalised Count Data Models

Modelling Hospital Admission and Length of Stay by Means of Generalised Count Data Models
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通过广义计数数据模型对入院和住院时间进行建模

DOI:
10.1002/jae.2454
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发表时间:
2016
影响因子:
2.1
通讯作者:
Strumann
Strumann
中科院分区:
经济学3区
文献类型:
--
作者:
Herwartz;Strumann

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对于一个大的异质性组的患者,我们分析了入院的概率和分布特性的住院时间的条件个人的决定因素。采用零膨胀和过度分散计数数据的贝叶斯结构加性回归模型。此外,该框架扩展到障碍规格,提供了一种替代方法,以涵盖计数数据中特别大的频率零报价。作为一个特定的优点,模型类考虑嵌入所有分布参数的协变量的线性和非线性效应。线性效应表明,既往疾病的数量和严重程度与入院风险呈正相关,而医疗预防(以全科就诊的形式)和康复减少了未来住院的预期时间。灵活的非线性反应模式被诊断为年龄和患者的社会经济地位的指标。我们发现,社会剥夺对入院风险产生积极影响,对入院患者未来的预期住院时间产生负面影响。版权所有© 2015约翰威利父子有限公司.
For a large heterogeneous group of patients, we analyse probabilities of hospital admission and distributional properties of lengths of hospital stay conditional on individual determinants. Bayesian structured additive regression models for zero‐inflated and overdispersed count data are employed. In addition, the framework is extended towards hurdle specifications, providing an alternative approach to cover particularly large frequencies of zero quotes in count data. As a specific merit, the model class considered embeds linear and nonlinear effects of covariates on all distribution parameters. Linear effects indicate that the quantity and severity of prior illness are positively correlated with the risk of hospital admission, while medical prevention (in the form of general practice visits) and rehabilitation reduce the expected length of future hospital stays. Flexible nonlinear response patterns are diagnosed for age and an indicator of a patients' socioeconomic status. We find that social deprivation exhibits a positive impact on the risk of admission and a negative effect on the expected length of future hospital stays of admitted patients. Copyright © 2015 John Wiley & Sons, Ltd.
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