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Activity Number:
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238
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Type:
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Topic Contributed
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Date/Time:
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Tuesday, August 8, 2006 : 8:30 AM to 10:20 AM
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Sponsor:
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Section on Health Policy Statistics
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| Abstract - #305840 |
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Title:
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Hierarchical and Joint Site-Edge Methods for Medicare Hospice Service Region Boundary Analysis
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Author(s):
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Haijun Ma*+ and Bradley P. Carlin and Sudipto Banerjee
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Companies:
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University of Minnesota and University of Minnesota and University of Minnesota
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Address:
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1188 Gibbs Ave., N1, Falcon Heights, MN, 55108,
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Keywords:
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health services research ; wombling ; areal data ; conditionally autoregressive (CAR) model ; Ising model ; boundary analysis
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Abstract:
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Hospice service, a convenient and ethically preferable health care option for the terminally ill, is unavailable to patients in remote areas not served by any hospice system. In this paper, we seek to determine the service area of two hospice systems in northeastern Minnesota based on only death counts abstracted from Medicare billing records. We suggest a variety of hierarchical models for areal boundary analysis that hierarchically or jointly parameterize both the areas and the edge segments. This leads to conceptually appealing solutions for our data that remain computationally feasible. Our results successfully delineate service areas for our two Minnesota hospice systems that sometimes conflict with the hospices' own service area self-reports. We also obtain boundaries for the relative rate of hospice use, an important secondary endpoint in our investigation.
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