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Biostatistics Advance Access published online on May 25, 2005
Biostatistics, doi:10.1093/biostatistics/kxi036
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© The Author 2005. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oupjournals.org.
Received August 16, 2004
Revised May 6, 2005
Accepted May 20, 2005

Article

Longitudinal profiling of health care units based on continuous and discrete patient outcomes

Michael Daniels Sc.D.1* and Sharon-Lise T. Normand Ph.D.2

1 Department of Statistics, University of Florida, Gainesville, FL 32611
2 Department of Health Care Policy, Harvard Medical School Boston, MA 02115; Department of Biostatistics, Harvard School of Public Health Boston, MA 02115

* To whom correspondence should be addressed.
Michael Daniels, E-mail: mdaniels{at}stat.ufl.edu


  Abstract

Monitoring health care quality involves combining continuous and discrete outcomes measured on subjects across health care units over time. This article describes a Bayesian approach to jointly modeling multilevel multidimensional continuous and discrete outcomes with serial dependence. The overall goal is to characterize trajectories of traits of each unit. Underlying normal regression models for each outcome are used and dependence among different outcomes is induced through latent variables. Serial dependence is accommodated through modeling the pairwise correlations of the latent variables. Methods are illustrated to assess trends in quality of health care units using continuous and discrete outcomes from a sample of adult veterans discharged from one of twenty-two Veterans Integrated Service Networks with a psychiatric diagnosis between 1993 and 1998.


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