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The use of finite mixture models to estimate the distribution of the health utilities index in the presence of a ceiling effect

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  • Peter Austin
  • Michael Escobar

Abstract

Finite mixture models are flexible parametric models that allow one to describe complex probability distributions as a mixture of a small number of simple probability distributions. Measures of health status are often used to reflect a person's overall health. Such measures may be subject to a ceiling effect, in that the measure is unable to discern gradations in health status above the ceiling. The purpose of this paper is to illustrate the use of finite mixture models to describe the probability distribution of the Health Utilities Index, under the assumption that the HUI is subject to a ceiling effect. Mixture models with two through six components are fit to the HUI. Bayes factors were used to compare the evidence that the Canadian population of non-institutionalized residents is composed of four distinct subpopulations, and that a mixture of six Normal components is required to describe these four subpopulations.

Suggested Citation

  • Peter Austin & Michael Escobar, 2003. "The use of finite mixture models to estimate the distribution of the health utilities index in the presence of a ceiling effect," Journal of Applied Statistics, Taylor & Francis Journals, vol. 30(8), pages 909-923.
    • Handle: RePEc:taf:japsta:v:30:y:2003:i:8:p:909-923
    DOI: 10.1080/0266476032000075985
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    References listed on IDEAS

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    1. James Tobin, 1956. "Estimation of Relationships for Limited Dependent Variables," Cowles Foundation Discussion Papers 3R, Cowles Foundation for Research in Economics, Yale University.
    2. Han C. & Carlin B. P., 2001. "Markov Chain Monte Carlo Methods for Computing Bayes Factors: A Comparative Review," Journal of the American Statistical Association, American Statistical Association, vol. 96, pages 1122-1132, September.
    3. G Torrance & Y Zhang & D Feeny & W Furlong & R Barr, 1992. "Multi-attribute Utility Functions for a Comprehensive Health Status Classification System: Health Utilities Index Mark 2," Centre for Health Economics and Policy Analysis Working Paper Series 1992-18, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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