The coxian phase-type distribution as a contribution to the multilevel model of in-hospital mortality

Abstract

This paper presents multi-level models that utilise the Coxian phase-type distribution in order to be able to include a survival component in the model. The approach is demonstrated by modelling patient length of stay and in-hospital mortality in geriatric wards in Italy. The multi-level model is used to provide a means of controlling for the existence of possible intra-ward correlations, which may make patients within a hospital more alike in terms of experienced outcome than patients coming from different hospitals, everything else being equal. Within this multi-level model we introduce the use of the Coxian phasetype distribution to create a covariate that represents patient length of stay or stage (of hospital care). Results demonstrate that the use of the multi-level model for representing the in-patient mortality is successful and further enhanced by the inclusion of the Coxian phase-type distribution variable (stage covariate).

Developing Sustainable Hospital Capacity Management Protocols Using Clinical Prognostic Analysis: A Novel Stochastic Model for Covid-19

“…CPTDs, which belong to the widely utilized PTDs, constitute a distinct subset that was originally introduced by Neuts in 1975 . One advantage of CPTDs is their ability to address the issue of generality in PTDs by necessitating only a limited number of parameters used to explain a distribution through n phases, however the general PTD needs n 2 + n parameters [57,58].…”

“…The conceptualization of this process involved envisioning a series of progressions through underlying phases, ultimately leading to the occurrence of departing from the university upon graduation. The CPTD was utilized as a suitable framework for capturing and analyzing this dynamic process [58,60]. The majority of applications involving the CPTD have focused on modelling the duration of hospital stays.…”