University of Hertfordshire

The Analyses of Individual Patient Pathways: Investigating Regional Variation in COPD readmissions

Research output: Chapter in Book/Report/Conference proceedingConference contribution

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Original languageEnglish
Title of host publicationApplied Stochastic Models and Data Analysis
Subtitle of host publicationASMDA 2009 proceedings
EditorsL. Sakalauskas, C. Skiadas, E. K. Zavadskas
PublisherVilnius Gediminas Technical University Publishing House “Technika”
Pages316-319
ISBN (Print)978-9955-28-463-5
Publication statusPublished - 13 Jul 2009
EventApplied Stochastic Models & Data Analysis (ASMDA 2009) - Vilnius, Lithuania
Duration: 30 Jun 20093 Jul 2009

Conference

ConferenceApplied Stochastic Models & Data Analysis (ASMDA 2009)
CountryLithuania
CityVilnius
Period30/06/093/07/09

Abstract

Regional variation for those treated for chronic obstructive pulmonary disease (COPD) has been studied amongst many public health issues. However, for those experiencing frequent readmissions were not considered. The objective is to determine the probability of a patient being in the high risk group in their next readmission, given patient and regional specific previous readmissions, i.e. capturing individual clinical pathways of patient's leading to multiple readmissions. Data on COPD patients were extracted from the national (England) hospital episodes statistics (HES) dataset. Individual patient pathways
from initial admission through to more than four readmissions are captured. Here, patients are classified into the low risk of readmission group (LRRG) and the high risk of readmission group (HRRG). This classification is based on the definition of readmission, where we have previously developed a stochastic
modelling approach to determine the appropriate width of a time window in defining readmission. Hence, using this classification as a response variable, a marginal continuation-ratio logit model is used to examine regional disparities in progressing through multiple readmissions. Significant regional differences were found in each readmission and classification groups (HRRG or LRRG). For example, COPD patients from the North West of England were found to be 16% more likely to experience multiple readmissions than Yorkshire and The Humber region.

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