Multilevel models and health economics

Abstract

Multilevel analyses have become an accepted statistical technique in the field of education where over the past decade or so the methods have been developed to explore the relationships between pupil characteristics and the characteristics of the schools they attend. More recently, widespread use has extended to other social sciences and health research. However, to date, little use has been made of these techniques within the health economics literature. This paper presents an introductory account of multilevel models and describes some of the areas of health economics research that may benefit from their use.

Explaining variations in breast cancer screening across European countries

“…We feel that this is a reasonably low ¿gure. 15 For a nice overview of multilevel models and the application of these models in health economics see Rice and Leyland (1996) or Rice and Jones (1997). 16 By assumption the both error terms have zero mean and constant variances ( ).…”

What can we learn from a cross-country comparison of the costs of child delivery?

“…We used a multilevel modelling approach that accommodated the hierarchical nature of our data; in other words, data on hospitals (level 1) were nested within country (level 2) groups (Rice and Jones, 1997;Grieve et al, 2004). In its simplest form, the basic model for exploring variations in costs/resource use across and within countries was specified as follows:…”

Developing the formula for state subsidies for health care in Finland

“…This holds particularly for non-psychiatric specialist care and psychiatric care, but can also have an effect on primary care and care for the elderly. This problem can be handled with a multilevel model with random effect (20). In this case the specification can be evaluated using the Lagrange multiplier test (18).…”