A Stochastic Model to Measure Patient Effects Stemming from Hospital-Acquired Infections

George T. Kastner and Richard H. Shachtman
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George T. Kastner: Instituto de Estudios Superiores de Administration, Caracas, Venezuela
Richard H. Shachtman: University of North Carolina, Chapel Hill, North Carolina

Operations Research, 1982, vol. 30, issue 6, 1105-1133

Abstract: We introduce a Markov chain model to represent a patient's path in terms of the number and type of infections s/he may have acquired during a hospitalization period. The model allows for categories of patient diagnoses, surgery, the four major types of nosocomial (hospital-acquired) infections, and discharge or death Data from a national medical records survey including 58,647 patients enable us to estimate transition probabilities and, ultimately, perform statistical tests of fit, including a validation test. Novel parameterizations (functions of the transition matrix) are introduced to answer research questions on time-dependent infection rates, time to discharge or death as a function of patient diagnostic groups and conditional infection rates reflecting intervening variables (e.g., surgery).

Keywords: 222 predicting progress of patients with and without infections; 276 hospital-based Markov chain model; effects of infections; 570 Markov chain models in the hospital (search for similar items in EconPapers)
Date: 1982
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