JSM 2005 Online Program

Abstract #303317

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Activity Number:	194
Type:	Contributed
Date/Time:	Monday, August 8, 2005 : 2:00 PM to 3:50 PM
Sponsor:	Section on Health Policy Statistics
Abstract - #303317
Title:	A Hierarchical Model for Multiple Binary Process Measures
Author(s):	Robert B. Gerzoff*+ and Theodore J. Thompson
Companies:	Centers for Disease Control and Prevention and Centers for Disease Control and Prevention
Address:	Division of Diabetes Translation, Atlanta, GA, 30341, United States
Keywords:
Abstract:	Multiple binary outcomes are a common feature of many health care Investigations. Rather than aggregating these binary measures into a summary score, Ribaudo (2002) suggested a hierarchical model for analysis. Here, we explore Ribaudo's proposed hierarchical model for the analysis of multiple, binary, health process outcomes in a study of managed care diabetes patients. Data are taken from the TRIAD study, a multicenter prospective cohort study. We use the hierarchical structure of the model to account for the correlation between patients within health plans. We simultaneously model six binary outcomes for more than 8000 patients nested in 10 health plans. Independent predictors include, age, race, gender, Charlson comorbidity score, and medical treatment. As in Ribaudo's work, parameter estimates obtained from fitting this joint model differ little from those obtained by modeling each outcome separately. The joint model does, however, provide useful and otherwise unavailable information about the correlation between the bivariate health process outcomes.

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