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Using phase-type models to cost stroke patient care across health, social and community services

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  • McClean, Sally
  • Gillespie, Jennifer
  • Garg, Lalit
  • Barton, Maria
  • Scotney, Bryan
  • Kullerton, Ken

Abstract

Stroke disease places a heavy burden on society, incurring long periods of time in hospital and community care, and associated costs. Also stroke is a highly complex disease with diverse outcomes and multiple strategies for therapy and care. Previously a modeling framework has been developed which clusters patients into classes with respect to their length of stay (LOS) in hospital. Phase-type models were then used to describe patient flows for each cluster. Also multiple outcomes, such as discharge to normal residence, nursing home, or death can be permitted. We here add costs to this model and obtain the Moment Generating Function for the total cost of a system consisting of multiple transient phase-type classes with multiple absorbing states. This system represents different classes of patients in different hospital and community services states. Based on stroke patients’ data from the Belfast City Hospital, various scenarios are explored with a focus on comparing the cost of thrombolysis treatment under different regimes. The overall modeling framework characterizes the behavior of stroke patient populations, with a focus on integrated system-wide costing and planning, encompassing hospital and community services. Within this general framework we have developed models which take account of patient heterogeneity and multiple care options. Such complex strategies depend crucially on developing a deep engagement with the health care professionals and underpinning the models with detailed patient-specific data.

Suggested Citation

  • McClean, Sally & Gillespie, Jennifer & Garg, Lalit & Barton, Maria & Scotney, Bryan & Kullerton, Ken, 2014. "Using phase-type models to cost stroke patient care across health, social and community services," European Journal of Operational Research, Elsevier, vol. 236(1), pages 190-199.
    • Handle: RePEc:eee:ejores:v:236:y:2014:i:1:p:190-199
    DOI: 10.1016/j.ejor.2014.01.063
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    References listed on IDEAS

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    1. Alexopoulos, Christos & Goldsman, David & Fontanesi, John & Kopald, David & Wilson, James R., 2008. "Modeling patient arrivals in community clinics," Omega, Elsevier, vol. 36(1), pages 33-43, February.
    2. Mark Fackrell, 2009. "Modelling healthcare systems with phase-type distributions," Health Care Management Science, Springer, vol. 12(1), pages 11-26, March.
    3. Jennifer Gillespie & Sally McClean & Bryan Scotney & Lalit Garg & Maria Barton & Ken Fullerton, 2011. "Costing hospital resources for stroke patients using phase-type models," Health Care Management Science, Springer, vol. 14(3), pages 279-291, September.
    4. Sundberg, Gun & Bagust, Adrian & Terent, Andreas, 2003. "A model for costs of stroke services," Health Policy, Elsevier, vol. 63(1), pages 81-94, January.
    5. Nicola J. Cooper & Keith R. Abrams & Alex J. Sutton & David Turner & Paul C. Lambert, 2003. "A Bayesian approach to Markov modelling in cost‐effectiveness analyses: application to taxane use in advanced breast cancer," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 166(3), pages 389-405, October.
    6. Sofia Dimakou & David Parkin & Nancy Devlin & John Appleby, 2009. "Identifying the impact of government targets on waiting times in the NHS," Health Care Management Science, Springer, vol. 12(1), pages 1-10, March.
    7. Harper, P.R. & Knight, V.A. & Marshall, A.H., 2012. "Discrete Conditional Phase-type models utilising classification trees: Application to modelling health service capacities," European Journal of Operational Research, Elsevier, vol. 219(3), pages 522-530.
    8. K Katsaliaki & N Mustafee, 2011. "Applications of simulation within the healthcare context," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 62(8), pages 1431-1451, August.
    9. Arnoud Bruin & A. Rossum & M. Visser & G. Koole, 2007. "Modeling the emergency cardiac in-patient flow: an application of queuing theory," Health Care Management Science, Springer, vol. 10(2), pages 125-137, June.
    10. K Cooper & S C Brailsford & R Davies, 2007. "Choice of modelling technique for evaluating health care interventions," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(2), pages 168-176, February.
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    Cited by:

    1. Bruce Jones & Sally McClean & David Stanford, 2019. "Modelling mortality and discharge of hospitalized stroke patients using a phase-type recovery model," Health Care Management Science, Springer, vol. 22(4), pages 570-588, December.
    2. P. -C. G. Vassiliou, 2022. "Limiting Distributions of a Non-Homogeneous Markov System in a Stochastic Environment in Continuous Time," Mathematics, MDPI, vol. 10(8), pages 1-16, April.
    3. P.-C.G. Vassiliou, 2021. "Non-Homogeneous Markov Set Systems," Mathematics, MDPI, vol. 9(5), pages 1-25, February.
    4. Sally McClean, 2021. "Using Markov Models to Characterize and Predict Process Target Compliance," Mathematics, MDPI, vol. 9(11), pages 1-12, May.

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