The Graphical Presentation of a Collection of Means

Goldstein, Harvey; Healy, M. J. R.

doi:10.2307/2983411

Cited by 470 publications

(381 citation statements)

References 1 publication

Supporting

Mentioning

357

Contrasting

Unclassified

Order By: Relevance

“…However, note that the CrIs are appropriate only for comparisons against zero, but are too wide for comparison of any two hospitals. 62 Third, CrIs on the mobility dimension are wider than on any other dimension of the EQ-5D. This reflects the lesser amount of information contained in the data, with only two mobility categories being reasonably well populated.…”

Section: Risk-adjusted Hospital Performance On Individual Eq-5d Dimenmentioning

confidence: 98%

Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data

Street

Gutacker

Bojke

et al. 2014

Health Services and Delivery Research

View full text Add to dashboard Cite

BackgroundIt is important that NHS resources are used to their full extent, but efforts to reduce costs may have an adverse effect on patient outcomes. Our research is designed to provide a better understanding of the inter-relationship between costs and health outcomes among NHS providers (hospitals) for common surgical procedures.ObjectivesIn England, patient-reported outcomes measures (PROMs) are collected from patients undergoing one of four elective procedures: unilateral hip replacement, unilateral knee replacement, groin hernia repair and varicose vein surgery. We identify variation in patient-reported outcomes (PROs) across hospitals, assess the relationship between the cost and outcomes among NHS hospitals for these procedures, and determine the extent to which variations in outcomes and costs are due to differences in hospital performance.Data sourcesWe link Hospital Episode Statistics (HES) data with reference cost data and PROM data for patients having the four treatments between April 2009 and March 2010.MethodsThe first part of the empirical analysis focuses on variation in different dimensions of self-reported health status. We argue that each of the EuroQol-5D questionnaire (EQ-5D; European Quality of Life-5 Dimensions) dimensions should be assessed separately. Our graphical summary of the differential impact that hospitals have on PROs indicates the probability of reporting a given health outcome and shows how these probabilities vary across EQ–5D dimensions and hospitals. The second part of the empirical analysis focuses on the performance of hospitals and the inter-relationship between PROs and resource use.ResultsWe find that poorer post-treatment health status is associated with lower initial health status, higher weighted Charlson score, more diagnoses and lower socioeconomic status. We find significantly unexplained variation among hospitals in outcomes for patients undergoing hip replacement, knee replacement or varicose vein surgery, but not for hernia patients. For all four treatments we find significant unexplained variation in resource use among hospitals, whether measured by cost of treatment or length of stay. This suggests that hospitals can improve their utilisation of resources.LimitationsOur analyses are based on the HES. If data are missing from the medical record, or extracted and coded inaccurately, HES will contain errors. Hospitals should minimise these errors. Our study suffers from a large number of missing data, mainly because some hospitals were better than others at administering the baseline survey.ConclusionsThere is no general evidence that hospitals with lower resource use have worse health outcomes. There is a significant positive correlation for varicose veins, but this is sensitive to the choice of resource use and PRO measures. For hip and knee replacement the correlation is either insignificant or negative (depending on the resource use and PRO measures), implying that promoting health outcomes and controlling costs are not contradictory objectives. Indeed, we are able to identify hospitals with better than expected outcomes where resource use is below average. Future research should address how to handle missing data, evaluate hospital performance within the broader health economy, communicate PROMs to prospective patients, evaluate the impact of PROMs on patient choice and provider behaviour and evaluate PROMs for people with chronic conditions.FundingThe National Institute for Health Research Health Service and Delivery Research programme.

show abstract

Section: Risk-adjusted Hospital Performance On Individual Eq-5d Dimenmentioning

confidence: 98%

Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data

Street

Gutacker

Bojke

et al. 2014

Health Services and Delivery Research

View full text Add to dashboard Cite

show abstract

“…Goldstein and Healy (1995) demonstrated that 95% CIs can overlap substantially and yet two means will be significantly different at the 5% level. They showed that if the standard errors of two independent means are approximately equal, then non-overlapping 84% CIs are equivalent to a t-test of these means at the .05 level (see also Tyron, 2001).…”

Section: Mean-level Changementioning

confidence: 99%

Age differences in five personality domains across the life span.

Allemand¹,

Zimprich²,

Hendriks³

2008

Developmental Psychology

137

127

View full text Add to dashboard Cite

The present study addresses the issue of age differences in five personality domains across the lifespan in a cross-sectional study. In contrast to most previous studies, we followed a methodologically more rigorous approach to warrant that age-related differences in personality structure and mean-level can be meaningfully compared. We used data on 50 items of the Five-Factor Personality Inventory (FFPI) available from a study in a large and representative Dutch sample (N = 2494, age range: 16-91 years) conducted in 1996 for the purpose of establishing norms for the FFPI. After having established strict measurement invariance, we tested for factor covariances to be equal across age groups, and found structural continuity of personality. Additionally, factor variances were shown to be equal across age groups. A number of age differences in the mean-level of the five personality domains emerged. Specifically, older adults were, on average, more agreeable and, especially, more conscientious than middle-aged and younger adults. Findings from our study suggest that both continuity and change may mark personality over the course of life. The present study addresses the issue of age differences in five personality domains across the lifespan in a cross-sectional study. In contrast to most previous studies, we followed a methodologically more rigorous approach to warrant that age-related differences in personality structure and mean-level can be meaningfully compared. We used data on 50 items of the Five-Factor Personality Inventory (FFPI) available from a study in a large and representative Dutch sample (N = 2494, age range: 16-91 years) conducted in 1996 for the purpose of establishing norms for the FFPI. After having established strict measurement invariance, we tested for factor covariances to be equal across age groups, and found structural continuity of personality. Additionally, factor variances were shown to be equal across age groups. A number of age differences in the mean-level of the five personality domains emerged. Specifically, older adults were, on average, more agreeable and, especially, more conscientious than middle-aged and younger adults. Findings from our study suggest that both continuity and change may mark personality over the course of life.

show abstract

“…Till recently, there have been generally two traditional statistical procedures to deal with them: 1) the first procedure is to disaggregate all higher order variables to the individual level and carry out the analysis at individual level. Here, assumption of independence of observations cannot be ensured that is basic for the classical statistical techniques and hence can provide distorted results [1,2]; and 2) the second procedure is to aggregate the individual level variables to the higher level and do the analysis at higher level. Under this approach, all the within group information (variation) are thrown away which may be as much as 80% or 90% of the total variation before we start the analysis.…”

Section: Introductionmentioning

confidence: 99%

Community effects on public health in India: A hierarchical model

Dwivedi¹,

Begum²,

Dwived³

et al. 2012

Health

View full text Add to dashboard Cite

The data on any aspect of public health, including that on infant mortality, has inbuilt hierarchical structure. Using traditional regression approach in data analysis, i.e., ignoring hierarchical structure, either at micro (individual) or at macro (community) level will be avoiding desired assumption related to independence of records. Accordingly, this may result into distortion in the results due to probable underestimation of standard error of the regression coefficients. To be more specific, an irrelevant covariate may emerge as an important covariate leading to inappropriate public health implications. To overcome this problem, the objective of the present work was to deal with multilevel analysis of the data on infant mortality available under second round of National family Health Survey and notify changes in results under traditional regression analysis that ignores hierarchical structure of data. This method provides more accurate results leading to meaningful public health implications. In addition, estimation of variability at different levels and their covariance are also obtained. The results indicate that the community (e.g., state) level characteristics still have major role regarding infant mortality in India. Further, if computational facilities are available, multilevel analysis may be preferred in dealing with data involving hierarchical structure leading to accurate results having meaningful public health implications.

show abstract

The Graphical Presentation of a Collection of Means

Cited by 470 publications

References 1 publication

Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data

Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data

Age differences in five personality domains across the life span.

Community effects on public health in India: A hierarchical model

Contact Info

Product

Resources

About