JOURNAL ARTICLE

A robustified modeling approach to analyze pediatric length of stay

Andy H Lee, Michael Gracey, Kui Wang, Kelvin K W Yau
Annals of Epidemiology 2005, 15 (9): 673-7
16157254

PURPOSE: Length of stay (LOS) is an important measure of the cost of pediatric hospitalizations, but the guidelines developed so far are not rigorously evidence-based. This study demonstrates a robust gamma mixed regression approach to analyze the positively skewed LOS variable, which has implications for future studies of pediatric health care management.

METHODS: The robustified approach is applied to analyze hospital discharge data on childhood gastroenteritis in Western Australia (n=514). The model accounts for demographic characteristics and co-morbidities of the patients, as well as the dependency of LOS outcomes nested within the 58 hospitals in the State. The method is compared with the standard linear mixed regression with trimming of extreme observations.

RESULTS: For the empirical application, the linear mixed regression results are sensitive to the magnitude of trimming. The identified significant factors from the robust regression model, namely infection, failure to thrive, and iron deficiency anemia are resistant to high-LOS outliers.

CONCLUSIONS: Robust gamma mixed regression appears to be a suitable alternative to analyze the clustered and positively skewed pediatric LOS, without transforming and trimming the data arbitrarily.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
16157254
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"