The Coxian phase-type distribution as a contribution to the multilevel model of in-hospital mortality

M. Zenga, A. H. Marshall, Franca Crippa, Hannah Mitchell

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Abstract

This paper presents multilevel models that utilize the Coxian phase-type distribution in order to be able to include a survival component in the model. The approach is demonstrated by modeling patient length of stay and in-hospital mortality in geriatric wards in Italy. The multilevel model is used to provide a means of controlling for the existence of possible intra-ward correlations, which may make patients within a hospital more alike in terms of experienced outcome than patients coming from different hospitals, everything else being equal. Within this multilevel model we introduce the use of the Coxian phase-type distribution to create a covariate that represents patient length of stay or stage (of hospital care). Results demonstrate that the use of the multilevel model for representing the in-patient mortality is successful and further enhanced by the inclusion of the Coxian phase-type distribution variable (stage covariate).
Original languageEnglish
Pages (from-to)1819-1830
Number of pages12
JournalCommunications in Statistics: Theory and Methods
Volume45
Issue number6
Early online date09 Nov 2015
DOIs
Publication statusPublished - 01 Apr 2016

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