Longitudinal profiling of health care units based on continuous and discrete patient outcomes.
Monitoring health care quality involves combining continuous and discrete outcomes measured on subjects across health care units over time. This article describes a Bayesian approach to jointly modeling multilevel multidimensional continuous and discrete outcomes with serial dependence. The overall goal is to characterize trajectories of traits of each unit. Underlying normal regression models for each outcome are used and dependence among different outcomes is induced through latent variables. Serial dependence is accommodated through modeling the pairwise correlations of the latent variables. Methods are illustrated to assess trends in quality of health care units using continuous and discrete outcomes from a sample of adult veterans discharged from 1 of 22 Veterans Integrated Service Networks with a psychiatric diagnosis between 1993 and 1998.
Daniels
Michael J
MJ
Department of Statistics, University of Florida, Gainesville, 32611, USA. mdaniels@stat.ufl.edu
Normand
Sharon-Lise T
SL
D001499:Bayes Theorem; D006302:Health Services Research; D006760:Hospitalization; D006787:Hospitals, Veterans / Q000592:standards*; D006801:Humans; D008137:Longitudinal Studies; D008605:Mental Health Services / Q000592:standards*; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011787:Quality of Health Care; D012044:Regression Analysis; D014481:United States; D014493:United States Department of Veterans Affairs / Q000592:standards*; D014728:Veterans