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Evaluation of long-term health care services through a latent Markov model with covariates

Author

Listed:
  • Giorgio E. Montanari

    (University of Perugia)

  • Silvia Pandolfi

    (University of Perugia)

Abstract

We focus on the evaluation of the long-term health care services provided to elderly patients by nursing homes of four different health districts in the Umbria region (Italy). To this end, we analyze data coming from a longitudinal survey aimed at assessing several aspects of patient health conditions and develop an extended version of the latent Markov model with covariates, which allows us to deal with dropout and intermittent missing data patterns that are common in longitudinal studies. Maximum likelihood estimates are obtained by a two-step approach that allows for fast estimation of model parameters and prevents some drawbacks of the standard maximum likelihood method encountered in the presence of many response variables and covariates. In the application to the observed data, we show how to obtain indicators of the effectiveness of the health care services delivered by each health district, by means of a resampling procedure.

Suggested Citation

  • Giorgio E. Montanari & Silvia Pandolfi, 2018. "Evaluation of long-term health care services through a latent Markov model with covariates," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 27(1), pages 151-173, March.
    • Handle: RePEc:spr:stmapp:v:27:y:2018:i:1:d:10.1007_s10260-017-0390-2
    DOI: 10.1007/s10260-017-0390-2
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    References listed on IDEAS

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    1. Bartolucci, Francesco & Montanari, Giorgio E. & Pandolfi, Silvia, 2015. "Three-step estimation of latent Markov models with covariates," Computational Statistics & Data Analysis, Elsevier, vol. 83(C), pages 287-301.
    2. S. Bacci & S. Pandolfi & F. Pennoni, 2014. "A comparison of some criteria for states selection in the latent Markov model for longitudinal 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. 8(2), pages 125-145, June.
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    Citations

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    Cited by:

    1. Joan Gil & Paolo Li Donni & Eugenio Zucchelli, 2019. "Uncontrolled diabetes and health care utilisation: A bivariate latent Markov model approach," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1262-1276, November.
    2. Giorgio E. Montanari & Marco Doretti, 2019. "Ranking Nursing Homes’ Performances Through a Latent Markov Model with Fixed and Random Effects," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 146(1), pages 307-326, November.
    3. Giorgio Eduardo Montanari & Marco Doretti & Maria Francesca Marino, 2022. "Model-based two-way clustering of second-level units in ordinal multilevel latent Markov models," 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(2), pages 457-485, June.

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