A shared random effects model for censored medical costs and mortality

Statistics in Medicine
Lei LiuJohn D Kalbfleisch

Abstract

In this paper, we propose a model for medical costs recorded at regular time intervals, e.g. every month, as repeated measures in the presence of a terminating event, such as death. Prior models have related monthly medical costs to time since entry, with extra costs at the final observations at the time of death. Our joint model for monthly medical costs and survival time incorporates two important new features. First, medical cost and survival may be correlated because more 'frail' patients tend to accumulate medical costs faster and die earlier. A joint random effects model is proposed to account for the correlation between medical costs and survival by a shared random effect. Second, monthly medical costs usually increase during the time period prior to death because of the intensive care for dying patients. We present a method for estimating the pattern of cost prior to death, which is applicable if the pattern can be characterized as an additive effect that is limited to a fixed time interval, say b units of time before death. This 'turn back time' method for censored observations censors cost data b units of time before the actual censoring time, while keeping the actual censoring time for the survival data. Time-depende...Continue Reading

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Citations

Jan 5, 2011·Evaluation & the Health Professions·Richard CharnigoRick S Zimmerman
Mar 14, 2008·Statistics in Medicine·Eva PaganoDario Gregori
Dec 7, 2007·Statistics in Medicine·Christel CastelliJean-Pierre Daures
May 15, 2013·Statistics in Medicine·Jinsong ChenYa-Chen T Shih
Oct 2, 2012·Statistics in Medicine·Huiping XuLaura Sands
Aug 8, 2018·Lifetime Data Analysis·Kwun Chuen Gary Chan
Sep 1, 2017·Lifetime Data Analysis·Jaeun ChoiJianwen Cai
Jul 27, 2017·Statistics in Medicine·Jenny Jeyarajah, Gengsheng Qin
Jan 1, 2018·Journal of the American Statistical Association·Liang LiYu Shen
Jan 1, 2018·Journal of the American Statistical Association·Shengchun KongRichard Hirth
Jul 12, 2017·Journal of the American Statistical Association·Kwun Chuen Gary Chan, Mei-Cheng Wang
Mar 23, 2017·Biometrical Journal. Biometrische Zeitschrift·Elisabeth WaldmannAndreas Mayr

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