A spatiotemporal quantile regression model for emergency department expenditures

Statistics in Medicine
Brian NeelonSara E Benjamin Neelon

Abstract

Motivated by a recent study of geographic and temporal trends in emergency department care, we develop a spatiotemporal quantile regression model for the analysis of emergency department-related medical expenditures. The model yields distinct spatial patterns across time for each quantile of the response distribution, which is important in the spatial analysis of expenditures, as there is often little spatiotemporal variation in mean expenditures but more pronounced variation in the extremes. The model has a hierarchical structure incorporating patient-level and region-level predictors as well as spatiotemporal random effects. We model the random effects via intrinsic conditionally autoregressive priors, improving small-area estimation through maximum spatiotemporal smoothing. We adopt a Bayesian modeling approach based on an asymmetric Laplace distribution and develop an efficient posterior sampling scheme that relies solely on conjugate full conditionals. We apply our model to data from the Duke support repository, a large georeferenced database containing health and financial data for Duke Health System patients residing in Durham County, North Carolina.

References

Dec 14, 1973·Science·J Wennberg, Gittelsohn
Dec 6, 2000·JAMA : the Journal of the American Medical Association·D C AngusUNKNOWN Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS)
Apr 22, 2005·Perspectives in Biology and Medicine·Katherine BaickerJonathan S Skinner
Aug 7, 2009·Health Services Research·Benjamin Lê Cook, Willard G Manning
Dec 7, 2010·Journal of Biomedical Informatics·Monica M HorvathJeffrey Ferranti
Mar 1, 2011·Journal of the American Statistical Association·Brian J ReichDavid B Dunson
Apr 2, 2013·Journal of the Royal Statistical Society. Series A, (Statistics in Society)·Brian NeelonPatrick F Loebs
Apr 18, 2013·Critical Care Medicine·Andrew A HerringCarlos A Camargo
Jul 19, 2013·Journal of the Royal Statistical Society. Series C, Applied Statistics·Brian J Reich
Sep 7, 2013·JAMA : the Journal of the American Medical Association·Joseph P Newhouse, Alan M Garber
Nov 14, 2013·JAMA : the Journal of the American Medical Association·Hamilton MosesSatoshi Yoshimura
Mar 22, 2014·Statistical Methods in Medical Research·Brian Neelon, Andrew B Lawson
Apr 1, 2014·Statistical Methods in Medical Research·Brian NeelonNicole S Hastings
Jan 1, 2009·The International Journal of Biostatistics·Yuan Liu, Matteo Bottai

❮ Previous
Next ❯

Citations

Dec 14, 2016·Journal of General Internal Medicine·Rebekah J WalkerLeonard E Egede

❮ Previous
Next ❯

Related Concepts

Related Feeds

Birth Defects

Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.