IDEAS home Printed from https://ideas.repec.org/a/spr/metron/v74y2016i3d10.1007_s40300-016-0098-3.html
   My bibliography  Save this article

Multilevel cluster-weighted models for the evaluation of hospitals

Author

Listed:
  • Paolo Berta

    (University of Milano-Bicocca)

  • Salvatore Ingrassia

    (University of Catania)

  • Antonio Punzo

    (University of Catania)

  • Giorgio Vittadini

    (University of Milano-Bicocca)

Abstract

In recent years, increasing attention has been directed toward problems inherent to quality control in healthcare services. In particular, it is necessary to measure effectiveness with respect to improving healthcare outcomes of diagnostic procedures or specific treatment episodes. The performance of hospitals is usually evaluated by multilevel models and other methods for risk adjustment. However, these approaches are not suitable for data with large unobserved heterogeneity. A potentially large source of unobserved heterogeneity comes from the variation of the regression coefficients between groups of individuals sharing similar but unobserved characteristics. To overcome such drawbacks, we propose the multilevel cluster-weighted model, a new mixture model approach for handling hierarchical data.

Suggested Citation

  • Paolo Berta & Salvatore Ingrassia & Antonio Punzo & Giorgio Vittadini, 2016. "Multilevel cluster-weighted models for the evaluation of hospitals," METRON, Springer;Sapienza Università di Roma, vol. 74(3), pages 275-292, December.
  • Handle: RePEc:spr:metron:v:74:y:2016:i:3:d:10.1007_s40300-016-0098-3
    DOI: 10.1007/s40300-016-0098-3
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40300-016-0098-3
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s40300-016-0098-3?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Ingrassia, Salvatore & Minotti, Simona C. & Punzo, Antonio, 2014. "Model-based clustering via linear cluster-weighted models," Computational Statistics & Data Analysis, Elsevier, vol. 71(C), pages 159-182.
    2. Luca Bagnato & Antonio Punzo, 2013. "Finite mixtures of unimodal beta and gamma densities and the $$k$$ -bumps algorithm," Computational Statistics, Springer, vol. 28(4), pages 1571-1597, August.
    3. Salvatore Ingrassia & Antonio Punzo & Giorgio Vittadini & Simona Minotti, 2015. "The Generalized Linear Mixed Cluster-Weighted Model," Journal of Classification, Springer;The Classification Society, vol. 32(1), pages 85-113, April.
    4. Martini, Gianmaria & Berta, Paolo & Mullahy, John & Vittadini, Giorgio, 2014. "The effectiveness–efficiency trade-off in health care: The case of hospitals in Lombardy, Italy," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 217-231.
    5. Jones, A. M. & Lomas, J. & Moore, P. & Rice, N., 2013. "A quasi-Monte Carlo comparison of developments in parametric and semi-parametric regression methods for heavy tailed and non-normal data: with an application to healthcare costs," Health, Econometrics and Data Group (HEDG) Working Papers 13/30, HEDG, c/o Department of Economics, University of York.
    6. Biernacki, Christophe & Celeux, Gilles & Govaert, Gerard, 2003. "Choosing starting values for the EM algorithm for getting the highest likelihood in multivariate Gaussian mixture models," Computational Statistics & Data Analysis, Elsevier, vol. 41(3-4), pages 561-575, January.
    7. Michel Wedel, 2002. "Concomitant variables in finite mixture models," Statistica Neerlandica, Netherlands Society for Statistics and Operations Research, vol. 56(3), pages 362-375, August.
    8. Karlis, Dimitris & Xekalaki, Evdokia, 2003. "Choosing initial values for the EM algorithm for finite mixtures," Computational Statistics & Data Analysis, Elsevier, vol. 41(3-4), pages 577-590, January.
    9. Dankmar Böhning & Ekkehart Dietz & Rainer Schaub & Peter Schlattmann & Bruce Lindsay, 1994. "The distribution of the likelihood ratio for mixtures of densities from the one-parameter exponential family," Annals of the Institute of Statistical Mathematics, Springer;The Institute of Statistical Mathematics, vol. 46(2), pages 373-388, June.
    10. Dubois, R.W. & Brook, R.H. & Rogers, W.H., 1987. "Adjusted hospital death rates: A potential screen for quality of medical care," American Journal of Public Health, American Public Health Association, vol. 77(9), pages 1162-1167.
    11. Harvey Goldstein & David J. Spiegelhalter, 1996. "League Tables and Their Limitations: Statistical Issues in Comparisons of Institutional Performance," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 159(3), pages 385-409, May.
    12. Salvatore Ingrassia & Simona Minotti & Giorgio Vittadini, 2012. "Local Statistical Modeling via a Cluster-Weighted Approach with Elliptical Distributions," Journal of Classification, Springer;The Classification Society, vol. 29(3), pages 363-401, October.
    13. Bengt Muthén & Tihomir Asparouhov, 2009. "Multilevel regression mixture analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 172(3), pages 639-657, June.
    14. McNicholas, P.D. & Murphy, T.B. & McDaid, A.F. & Frost, D., 2010. "Serial and parallel implementations of model-based clustering via parsimonious Gaussian mixture models," Computational Statistics & Data Analysis, Elsevier, vol. 54(3), pages 711-723, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Antonio Punzo & Paul. D. McNicholas, 2017. "Robust Clustering in Regression Analysis via the Contaminated Gaussian Cluster-Weighted Model," Journal of Classification, Springer;The Classification Society, vol. 34(2), pages 249-293, July.
    2. Michael P. B. Gallaugher & Salvatore D. Tomarchio & Paul D. McNicholas & Antonio Punzo, 2022. "Multivariate cluster weighted models using skewed distributions," Advances in Data Analysis and Classification, Springer;German Classification Society - Gesellschaft für Klassifikation (GfKl);Japanese Classification Society (JCS);Classification and Data Analysis Group of the Italian Statistical Society (CLADAG);International Federation of Classification Societies (IFCS), vol. 16(1), pages 93-124, March.
    3. Salvatore Ingrassia & Antonio Punzo, 2020. "Cluster Validation for Mixtures of Regressions via the Total Sum of Squares Decomposition," Journal of Classification, Springer;The Classification Society, vol. 37(2), pages 526-547, July.
    4. Engel, Christoph, 2020. "Estimating heterogeneous reactions to experimental treatments," Journal of Economic Behavior & Organization, Elsevier, vol. 178(C), pages 124-147.
    5. Angelo Mazza & Antonio Punzo, 2020. "Mixtures of multivariate contaminated normal regression models," Statistical Papers, Springer, vol. 61(2), pages 787-822, April.
    6. Alicia Ramírez-Orellana & María del Carmen Valls Martínez & Mayra Soledad Grasso, 2021. "Using Higher-Order Constructs to Estimate Health-Disease Status: The Effect of Health System Performance and Sustainability," Mathematics, MDPI, vol. 9(11), pages 1-23, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Antonio Punzo & Paul. D. McNicholas, 2017. "Robust Clustering in Regression Analysis via the Contaminated Gaussian Cluster-Weighted Model," Journal of Classification, Springer;The Classification Society, vol. 34(2), pages 249-293, July.
    2. Salvatore Ingrassia & Antonio Punzo, 2020. "Cluster Validation for Mixtures of Regressions via the Total Sum of Squares Decomposition," Journal of Classification, Springer;The Classification Society, vol. 37(2), pages 526-547, July.
    3. Angelo Mazza & Antonio Punzo, 2020. "Mixtures of multivariate contaminated normal regression models," Statistical Papers, Springer, vol. 61(2), pages 787-822, April.
    4. Salvatore Ingrassia & Antonio Punzo & Giorgio Vittadini & Simona Minotti, 2015. "The Generalized Linear Mixed Cluster-Weighted Model," Journal of Classification, Springer;The Classification Society, vol. 32(1), pages 85-113, April.
    5. Salvatore Ingrassia & Antonio Punzo & Giorgio Vittadini & Simona Minotti, 2015. "Erratum to: The Generalized Linear Mixed Cluster-Weighted Model," Journal of Classification, Springer;The Classification Society, vol. 32(2), pages 327-355, July.
    6. Utkarsh J. Dang & Antonio Punzo & Paul D. McNicholas & Salvatore Ingrassia & Ryan P. Browne, 2017. "Multivariate Response and Parsimony for Gaussian Cluster-Weighted Models," Journal of Classification, Springer;The Classification Society, vol. 34(1), pages 4-34, April.
    7. Morris, Katherine & Punzo, Antonio & McNicholas, Paul D. & Browne, Ryan P., 2019. "Asymmetric clusters and outliers: Mixtures of multivariate contaminated shifted asymmetric Laplace distributions," Computational Statistics & Data Analysis, Elsevier, vol. 132(C), pages 145-166.
    8. Hung Tong & Cristina Tortora, 2022. "Model-based clustering and outlier detection with missing data," Advances in Data Analysis and Classification, Springer;German Classification Society - Gesellschaft für Klassifikation (GfKl);Japanese Classification Society (JCS);Classification and Data Analysis Group of the Italian Statistical Society (CLADAG);International Federation of Classification Societies (IFCS), vol. 16(1), pages 5-30, March.
    9. O’Hagan, Adrian & Murphy, Thomas Brendan & Gormley, Isobel Claire, 2012. "Computational aspects of fitting mixture models via the expectation–maximization algorithm," Computational Statistics & Data Analysis, Elsevier, vol. 56(12), pages 3843-3864.
    10. Paul D. McNicholas, 2016. "Model-Based Clustering," Journal of Classification, Springer;The Classification Society, vol. 33(3), pages 331-373, October.
    11. Maruotti, Antonello & Punzo, Antonio, 2017. "Model-based time-varying clustering of multivariate longitudinal data with covariates and outliers," Computational Statistics & Data Analysis, Elsevier, vol. 113(C), pages 475-496.
    12. Sanjeena Subedi & Antonio Punzo & Salvatore Ingrassia & Paul McNicholas, 2015. "Cluster-weighted $$t$$ t -factor analyzers for robust model-based clustering and dimension reduction," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 24(4), pages 623-649, November.
    13. Faicel Chamroukhi, 2016. "Piecewise Regression Mixture for Simultaneous Functional Data Clustering and Optimal Segmentation," Journal of Classification, Springer;The Classification Society, vol. 33(3), pages 374-411, October.
    14. Nicolas Depraetere & Martina Vandebroek, 2014. "Order selection in finite mixtures of linear regressions," Statistical Papers, Springer, vol. 55(3), pages 871-911, August.
    15. Diani, Cecilia & Galimberti, Giuliano & Soffritti, Gabriele, 2022. "Multivariate cluster-weighted models based on seemingly unrelated linear regression," Computational Statistics & Data Analysis, Elsevier, vol. 171(C).
    16. Papastamoulis, Panagiotis & Martin-Magniette, Marie-Laure & Maugis-Rabusseau, Cathy, 2016. "On the estimation of mixtures of Poisson regression models with large number of components," Computational Statistics & Data Analysis, Elsevier, vol. 93(C), pages 97-106.
    17. Salvatore D. Tomarchio & Paul D. McNicholas & Antonio Punzo, 2021. "Matrix Normal Cluster-Weighted Models," Journal of Classification, Springer;The Classification Society, vol. 38(3), pages 556-575, October.
    18. Ingrassia, Salvatore & Minotti, Simona C. & Punzo, Antonio, 2014. "Model-based clustering via linear cluster-weighted models," Computational Statistics & Data Analysis, Elsevier, vol. 71(C), pages 159-182.
    19. Počuča, Nikola & Jevtić, Petar & McNicholas, Paul D. & Miljkovic, Tatjana, 2020. "Modeling frequency and severity of claims with the zero-inflated generalized cluster-weighted models," Insurance: Mathematics and Economics, Elsevier, vol. 94(C), pages 79-93.
    20. Gabriele Soffritti, 2021. "Estimating the Covariance Matrix of the Maximum Likelihood Estimator Under Linear Cluster-Weighted Models," Journal of Classification, Springer;The Classification Society, vol. 38(3), pages 594-625, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:metron:v:74:y:2016:i:3:d:10.1007_s40300-016-0098-3. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.