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Negative Binomial and multilevel

John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK and other healthcare systems, however it remains uncertain how this can be achieved. This paper explores the relationship between unplanned ambulatory care sensitive condition (ACSC) admission rates and population, general practice and hospital characteristics. Additionally, we investigated if these factors had a differential impact across 28 conditions. METHODS: We used the English Hospital Episode Statistics to calculate the number of unplanned ACSC hospital admissions for 28 conditions at 8,029 general practices during 2011/12...
May 25, 2017: BMC Family Practice
Nguyen X. Thanh, Anderson W. Chuck, Tracy Wasylak, Jeannette Lawrence, Peter Faris, Olle Ljungqvist, Gregg Nelson, Leah M. Gramlich
BACKGROUND: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness, but also to inform strategy for the spread and scale of ERAS to other surgical protocols and sites. METHODS: We assessed the impact of ERAS on patients’ health services utilization (HSU; length of stay [LOS], readmissions, emergency department visits, general practitioner and specialist visits) within 30 days of discharge by comparing pre- and post-ERAS groups using multilevel negative binomial regressions...
December 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Daniele Maria Pelissari, Fredi Alexander Diaz-Quijano
Although many studies have identified social conditions associated with tuberculosis, contextual and individual factors have rarely been analysed simultaneously. Consequently, we aimed to identify contextual and individual factors associated with tuberculosis incidence in general population in Brazil in 2010. We also assessed whether household crowding mediates the association between socioeconomic determinants and tuberculosis incidence. Individual data of tuberculosis cases were obtained from 5,565 municipalities in Brazil in 2010 (last year of national census), and merged with contextual variables...
2017: PloS One
Jorge Browne, Duncan A Edwards, Kirsty M Rhodes, D James Brimicombe, Rupert A Payne
BACKGROUND: The majority of people with dementia have other long-term diseases, the presence of which may affect the progression and management of dementia. This study aimed to identify subgroups with higher healthcare needs, by analysing how primary care consultations, number of prescriptions and hospital admissions by people with dementia varies with having additional long-term diseases (comorbidity). METHODS: A retrospective cohort study based on health data from the Clinical Practice Research Datalink (CPRD) was conducted...
March 9, 2017: BMJ Open
Holly B Laws, Nicole E Ellerbeck, Alyne S Rodrigues, Jessica A Simmons, Emily B Ansell
BACKGROUND: Prior studies have found that social rejection is associated with increases in negative affect, distress, and hostility. Fewer studies, however, have examined the impact of social rejection on alcohol use, and no known studies have tested whether the impact of social rejection by close others differs from social rejection by acquaintances in its association with subsequent drinking. METHODS: Participants completed event-contingent reports of their social interactions and alcohol use for 14 consecutive days on smartphones...
April 2017: Alcoholism, Clinical and Experimental Research
Ester Angulo-Pueyo, Manuel Ridao-López, Natalia Martínez-Lizaga, Sandra García-Armesto, Salvador Peiró, Enrique Bernal-Delgado
OBJECTIVES: Potentially avoidable hospitalisations have been used as a proxy for primary care quality. We aimed to analyse the ecological association between contextual and systemic factors featured in the Spanish healthcare system and the variation in potentially avoidable hospitalisations for a number of chronic conditions. METHODS: A cross-section ecological study based on the linkage of administrative data sources from virtually all healthcare areas (n=202) and autonomous communities (n=16) composing the Spanish National Health System was performed...
February 24, 2017: BMJ Open
S S Paul, L Harvey, C G Canning, S Boufous, S R Lord, J C T Close, C Sherrington
BACKGROUND AND PURPOSE: Falls are common in people with Parkinson's disease (PD) but few data exist on fall-related hospitalizations in this group. This population-based study compared fall-related hospital admissions, injury rates and consequences in people with and without PD, and determined whether PD was an independent predictor of fall-related hospital length of stay. METHODS: This was a retrospective study using probabilistic linkage of hospital data in people aged ≥65 years hospitalized for a fall between 1 July 2005 and 31 December 2013 in New South Wales, Australia...
January 24, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Yunning Liu, Thomas Astell-Burt, Jiangmei Liu, Peng Yin, Xiaoqi Feng, Jinling You, Andrew Page, Maigeng Zhou, Lijun Wang
We investigated temporal trends and geographical variations in lung cancer mortality in China from 2006 to 2012. Lung cancer mortality counts for people aged over 40 years were extracted from the China Mortality Surveillance System for 161 disease surveillance points. Negative binomial regression was used to investigate potential spatiotemporal variation and correlations with age, gender, urbanization, and region. Lung cancer mortality increased in China over the study period from 78.77 to 85.63 (1/100,000), with higher mortality rates evident in men compared to women...
December 16, 2016: International Journal of Environmental Research and Public Health
Hyunil Kim, Brett Drake
This study examined the relationship of a family's duration in poverty-related programs (i.e., Aid to Families with Dependent Children/Temporary Assistance for Needy Families and Medicaid) to the subject child's number of maltreatment reports while considering race and baseline neighborhood poverty. Children from a large Midwestern metropolitan area were followed through a linked cross-sector administrative database from birth to age 15. Generalized multilevel models were employed to account for the multilevel structure of the data (i...
December 5, 2016: Child Maltreatment
Øystein Vedaa, Ståle Pallesen, Siri Waage, Bjørn Bjorvatn, Børge Sivertsen, Eilin Erevik, Erling Svensen, Anette Harris
OBJECTIVES: The purpose of this study was to use objective registry data to prospectively investigate the effects of quick returns (QR, <11 hours of rest between shifts) and night shifts on sick leave. METHODS: A total of 1538 nurses (response rate =41.5%) answered questionnaires on demographics and personality and provided consent to link this information to registry data on shift work and sick leave from employers' records. A multilevel negative binomial model was used to investigate the predictive effect of exposure to night shifts and QR every month for 1 year, on sick leave the following month...
November 8, 2016: Occupational and Environmental Medicine
Kate A Levin, Emilia M Crighton
This study describes trends in emergency admissions (EAs) in Glasgow City during a period when interventions were designed and implemented, aimed at shifting the balance from institutional to community-based care. Standardised monthly rates of EAs between April 2011 and March 2015 were calculated, for residents of Glasgow City aged 65 years and over. Multilevel zero-inflated Negative Binomial models for EAs nested by datazone were created, adjusting for sex, 5-year age group, area-level deprivation (SIMD quintile), season, month and month squared...
December 2016: Maturitas
Camilla L Wong, Raghda Al Atia, Amanda McFarlan, Holly Y Lee, Christina Valiaveettil, Barbara Haas
BACKGROUND: Proactive geriatric trauma consultation service (GTCS) models have been associated with better delivery of geriatric care and functional outcomes. Whether such collaborative models can be improved and sustained remains uncertain. We describe the sustainability and process improvements of an inpatient GTCS. METHODS: We assessed workflow using interviews and surveys to identify opportunities to optimize the referral process for the GTCS. Sustainability of the service was assessed via a prospective case series (July 2012-December 2013)...
February 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Matthew Gittins, Roseanne McNamee, Fiona Holland, Lesley-Anne Carter
OBJECTIVE: Accurate estimation of the true incidence of ill-health is a goal of many surveillance systems. In surveillance schemes including zero reporting to remove ambiguity with nonresponse, reporter fatigue might increase the likelihood of a false zero case report in turn underestimating the true incidence rate and creating a biased downward trend over time. STUDY DESIGN AND SETTING: Multilevel zero-inflated negative binomial models were fitted to incidence case reports of three surveillance schemes running between 1996 and 2012 in the United Kingdom...
January 2017: Journal of Clinical Epidemiology
E Alhelih, O Ghazi Baker, A E Aboshaiqah
This research aimed to describe changes in symptom occurrence and severity of the 31 symptoms during the chemotherapy cycle at three time points. This descriptive, longitudinal study investigated Saudi children who underwent a cycle of chemotherapy (n = 132) in four tertiary hospitals. The Arabic version of the Memorial Symptom Assessment Scale, Karnofsky Performance Status and a demographic questionnaire were used. More than 30% of children reported 10 or more symptoms during the cycle. Symptom occurrence trajectories were analysed using multilevel logistic regression...
July 20, 2016: European Journal of Cancer Care
Marzieh Mahmoodi, Abbas Moghimbeigi, Kazem Mohammad, Javad Faradmal
This study proposes semiparametric models for analysis of hierarchical count data containing excess zeros and overdispersion simultaneously. The methods discussed in this paper handle nonlinear covariate effects through flexible semiparametric multilevel regression techniques. This is performed by providing a comprehensive comparison of semiparametric multilevel zero-inflated negative binomial and semiparametric multilevel zero-inflated generalized Poisson models under the real and simulated data. An EM algorithm based on Newton-Raphson equations for maximum penalized likelihood estimation approach is developed...
July 7, 2016: Statistical Methods in Medical Research
Silvia A S Vedovello, Glaucia M B Ambrosano, Antonio C Pereira, Heloísa C Valdrighi, Mario Vedovello Filho, Marcelo de C Meneghim
INTRODUCTION: The purpose of this study was to examine associations among malocclusion and the contextual factors of quality of life and socioeconomic status. METHODS: A cross-sectional study was conducted with a population-based sample of 1256 children from 7 to 10 years old. Malocclusion was assessed clinically; oral health-related quality of life (OHRQoL) was assessed using the Brazilian version of the child perceptions questionnaire; socioeconomic status was determined from data made available by the Research and Planning Institute of Piracicaba, São Paulo, Brazil...
July 2016: American Journal of Orthodontics and Dentofacial Orthopedics
Sanjay Saint, M Todd Greene, Sarah L Krein, Mary A M Rogers, David Ratz, Karen E Fowler, Barbara S Edson, Sam R Watson, Barbara Meyer-Lucas, Marie Masuga, Kelly Faulkner, Carolyn V Gould, James Battles, Mohamad G Fakih
BACKGROUND: Catheter-associated urinary tract infection (UTI) is a common device-associated infection in hospitals. Both technical factors--appropriate catheter use, aseptic insertion, and proper maintenance--and socioadaptive factors, such as cultural and behavioral changes in hospital units, are important in preventing catheter-associated UTI. METHODS: The national Comprehensive Unit-based Safety Program, funded by the Agency for Healthcare Research and Quality, aimed to reduce catheter-associated UTI in intensive care units (ICUs) and non-ICUs...
June 2, 2016: New England Journal of Medicine
Charles DiMaggio, Spiros Frangos, Guohua Li
PURPOSE: Safe Routes to School (SRTS) was a federally funded transportation program for facilitating physically active commuting to and from school in children through improvements of the built environment. There is evidence that SRTS programs increase walking and bicycling in school-age children, but their impact on pedestrian and bicyclist safety has not been adequately examined. We investigate the impact and effects of the SRTS program on school-age pedestrian and bicyclist injuries in a nationwide sample in the United States...
June 2016: Annals of Epidemiology
Jennifer Meddings, Heidi Reichert, M Todd Greene, Nasia Safdar, Sarah L Krein, Russell N Olmsted, Sam R Watson, Barbara Edson, Mariana Albert Lesher, Sanjay Saint
BACKGROUND: The Agency for Healthcare Research and Quality (AHRQ) has funded national collaboratives using the Comprehensive Unit-based Safety Program to reduce rates of two catheter-associated infections-central-line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI), using evidence-based intervention bundles to improve technical aspects of care and socioadaptive approaches to foster a culture of safety. OBJECTIVE: Examine the association between hospital units' results for the Hospital Survey on Patient Safety Culture (HSOPS) and catheter-associated infection rates...
March 2017: BMJ Quality & Safety
Helenita Corrêa Ely, Claides Abegg, Roger Keller Celeste, Marcos Pascoal Pattussi
The Family Health Strategy (FHS) has produced effective results in health indicators. In this cross-sectional study, the impact of the oral health teams (OHT) of the Family Health Strategy was evaluated on the oral health of 2581 adolescent schoolchildren aged 12 and 15-19 years in 36 municipalities (19 with and 17 without OHT/FHS). Four dentists performed oral examinations. Socioeconomic status, the use of and access to health services were assessed via a structured questionnaire. The presence of the OHT in the FHS were the main independent variables...
May 2016: Ciência & Saúde Coletiva
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