Random effects models for operational patient pathways
Random effects models for operational patient pathways
复制标题
手术患者路径的随机效应模型
DOI：
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发表时间：
2010
期刊：
影响因子：
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通讯作者：
Md Asaduzaman
中科院分区：
文献类型：
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作者：
Shola Adeyemi;T. Chaussalet;Haifeng Xie;Md Asaduzaman
患者流建模是卫生服务研究中一个日益增长的领域。已应用多种技术对医疗机构内和医疗机构之间的患者移动进行建模。然而，在提供护理过程中，患者的个人经验一直被忽视。在这项工作中，一个随机效应模型被引入到病人流建模和应用到伦敦医院新生儿单元的数据。特别是，一个随机效应多项式logit模型被用来捕捉个别病人的轨迹在护理过程中与病人的弱点建模为随机效应。直观地，操作和临床患者流都被建模，前者是物理的，后者是潜在的。该模型的两个变种，提出了一个基于单纯的患者通路和其他基于患者的特点。我们的技术可以识别有趣的途径，例如导致死亡（生存）概率高的途径，产生最低（最高）护理成本的途径或住院时间最短（最长）的途径。还可以预测来自卫生保健系统的患者特定出院概率。保健管理人员在规划管理保健机构所需的稀缺资源时，对这些问题很感兴趣。
Patient flow modeling is a growing field of interest in health services research. Several techniques have been applied to model movement of patients within and between health-care facilities. However, individual patient experience during the delivery of care has always been overlooked. In this work, a random effects model is introduced to patient flow modeling and applied to a London Hospital Neonatal unit data. In particular, a random effects multinomial logit model is used to capture individual patient trajectories in the process of care with patient frailties modeled as random effects. Intuitively, both operational and clinical patient flow are modeled, the former being physical and the latter latent. Two variants of the model are proposed, one based on mere patient pathways and the other based on patient characteristics. Our technique could identify interesting pathways such as those that result in high probability of death (survival), pathways incurring the least (highest) cost of care or pathways with the least (highest) length of stay. Patient-specific discharge probabilities from the health care system could also be predicted. These are of interest to health-care managers in planning the scarce resources needed to run health-care institutions.
影响因子：
1.9
作者：
STIRATELLI, R;LAIRD, N;WARE, JH
通讯作者：
WARE, JH