The coxian phase-type distribution as a contribution to the multilevel model of in-hospital mortality. Issue 6 (18th March 2016)

• Record Type: Journal Article
• Authors: Zenga, Mariangela; Marshall, Adele H.; Crippa, Franca; Mitchell, Hannah
• Is Part Of: Communications in statistics. Volume 45:Issue 6(2016)
• Page Start: 1819
• Page End: 1830
• Publication Date: 2016-03-18
• Subjects: Coxian phase-type distribution -- Grouped survival model -- Multilevel model; Mathematical statistics -- Periodicals; Mathematics; Statistics; 519.2
• DOI: 10.1080/03610926.2015.1038394
• Languages: English
• ISSNs: 0361-0926

Abstract

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).