Methods for Improving Regression Analysis for Skewed Continuous or Counted Responses

Afifi, Abdelmonem A.; Kotlerman, Jenny; Ettner, Susan L.; Cowan, Marie J.

doi:10.1146/annurev.publhealth.28.082206.094100

Cited by 232 publications

(169 citation statements)

References 59 publications

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“…We reported incidence rate ratios (IRRs) with 95% confidence intervals (CIs) after performing zero-inflated negative binomial regressions 18,19 to account for overdispersed count outcome variables (mean length of stay, total length of stay, number of hospital admissions) with excess zeros. We used the Vuong nonnested test to assess the fit of the models.…”

Section: Discussionmentioning

confidence: 99%

Association between depression and hospital outcomes among older men

Prina

Huisman

Yeap

et al. 2012

CMAJ

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O lder people are the most frequent users of health services, and the progressive aging of the world's population may lead to a saturation of available services. Therefore, we must find ways to reduce preventable admissions to hospital and uncover the factors associated with potentially preventable use of health services. An association between depression and hospital admission for nonpsychiatric conditions has been postulated, although the data have been limited to specific clinical populations and the interpretation of the results hampered by the retrospective study design and the use of self-reported outcomes.1-8 Consequently, these findings cannot be easily generalized or used to develop data-driven interventions.We addressed this gap in the literature by using a community-based population survey with prospective data linkage to measure important health-related outcomes. Our main objective was to investigate whether community-dwelling older men with depressive symptoms were more likely than nondepressed men to be admitted to general hospitals. Our other aims were to determine whether the long-term clinical outcomes of these 2 groups differed in relation to the number of future hospital admissions, length of hospital stay and inpatient deaths. Methods Patient sampleWe identified and selected participants from a community-derived sample of 5585 men living in Perth, Western Australia, who collectively compose the Health in Men Study cohort. The Health in Men Study is a prospective, follow-up study involving men aged 69 years and older who participated in an earlier trial of screening for abdominal aortic aneurysm. The full details of the cohort, including assessment procedures and enrolment are available elsewhere. 9 In brief, 19 352 men aged 65-83 years were randomly selected between Apr. 1, 1996, and Jan. 31, 1999, from the electoral roll (enrolment is mandatory for Australian citizens) and invited to participate in the study. A total of 12 203 men completed the full questionnaire, which covered aspects of their lifestyle and medical history. The surviving men were invited to parAssociation between depression and hospital outcomes among older men

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Section: Discussionmentioning

confidence: 99%

Association between depression and hospital outcomes among older men

Prina

Huisman

Yeap

et al. 2012

CMAJ

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“…The mean predicted cost for each of these four scenarios adjusted the predictions for differences in the patients' covariates. 30 We used the four levels of activation, instead of the continuous activation score, to simplify the data display and more clearly show the nature of the relationships. It is often the case that instead of a monotonic relationship with an outcome, the patient activation measure shows a threshold effect, as was observed in this analysis.…”

Section: Study Data and Methodsmentioning

confidence: 99%

Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients’ ‘Scores’

2013

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Patient activation is a term that describes the skills and confidence that equip patients to become actively engaged in their health care. Health care delivery systems are turning to patient activation as yet another tool to help them and their patients improve outcomes and influence costs. In this article we examine the relationship between patient activation levels and billed care costs. In an analysis of 33,163 patients of Fairview Health Services, a large health care delivery system in Minnesota, we found that patients with the lowest activation levels had predicted average costs that were 8 percent higher in the base year and 21 percent higher in the first half of the next year than the costs of patients with the highest activation levels, both significant differences. What's more, patient activation was a significant predictor of cost even after adjustment for a commonly used "risk score" specifically designed to predict future costs. As health care delivery systems move toward assuming greater accountability for costs and outcomes for defined patient populations, knowing patients' ability and willingness to manage their health will be a relevant piece of information integral to health care providers' ability to improve outcomes and lower costs.

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“…We analyzed the coefficients according to the gender of the person that was hospitalized and the group of causes of hospitalization using Poisson regression with robust variance 16 , with respective confidence intervals and Wald statistical test. To assess the adequacy of the analyzed model, we used χ 2 -test, Goodness-of-fit, determining as an appropriate adjustment by p-value of > 0.05 17,18 . The coefficient of the Poisson regression showed the variation in hospitalization rates and mean periods of hospitalization for both groups of causes, according to gender, over the period.…”

Section: Methodsmentioning

confidence: 99%

Hospitalizações psiquiátricas no Rio Grande do Sul de 2000 a 2011

Horta

Costa

Balbinot

et al. 2015

Rev. bras. epidemiol.

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ABSTRACT:Objective: To examine the variation in the rates of psychiatric hospitalization and the mean hospital stay time in the public health system in the state of Rio Grande do Sul, in the south of Brazil, from 2000 to 2011. Methods: This was an ecological study. Data were collected from DATASUS. The rates were obtained from diagnosis of admissions due to psychoactive substance use and to other causes, stratified by the gender of the patients. The data were analyzed using Poisson regression and Spearman correlation coefficient. Results: Increasing hospitalization rates were observed for women with disorders due to substance use (p < 0.001) and other causes (p < 0.001), and among men with disorders due to the use of alcohol or other drugs (p < 0.001). This elevation of the rates remained statistically significant and inversely correlated to the length of hospital stay (p < 0.001). Discussion: In a period of expansion of the local care networks for mental health, an increase in the occupancy of psychiatric beds in the state was noticed, with shorter length of stay and greater diversity of gender and causes of hospitalization.

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Methods for Improving Regression Analysis for Skewed Continuous or Counted Responses

Cited by 232 publications

References 59 publications

Association between depression and hospital outcomes among older men

Association between depression and hospital outcomes among older men

Patients With Lower Activation Associated With Higher Costs; Delivery Systems Should Know Their Patients’ ‘Scores’

Hospitalizações psiquiátricas no Rio Grande do Sul de 2000 a 2011

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