A multi-state approach to patients affected by chronic heart failure

Francesco Grossetti (), Francesca Ieva () and Anna Maria Paganoni ()
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Francesco Grossetti: Universitá Commerciale L. Bocconi
Francesca Ieva: Politenico di Milano
Anna Maria Paganoni: Politenico di Milano

Health Care Management Science, 2018, vol. 21, issue 2, No 10, 291 pages

Abstract: Abstract Healthcare administrative databases are becoming more and more important and reliable sources of clinical and epidemiological information. They are able to track several interactions between a patient and the public healthcare system. In the present study, we make use of data extracted from the administrative data warehouse of Regione Lombardia, a region located in the northern part of Italy whose capital is Milan. Data are within a project aiming at providing a description of the epidemiology of Heart Failure (HF) patients at regional level, to profile health service utilization over time, and to investigate variations in patient care according to geographic area, socio-demographic characteristic and other clinical variables. We use multi-state models to estimate the probability of transition from (re)admission to discharge and death adjusting for covariates which are state dependent. To the best of our knowledge, this is the first Italian attempt of investigating which are the effects of pharmacological and outpatient cares covariates on patient’s readmissions and death. This allows to better characterise disease progression and possibly identify what are the main determinants of a hospital admission and death in patients with Heart Failure.

Keywords: Administrative data; Chronic heart failure; Multi-state models; Survival analysis; Data management (search for similar items in EconPapers)
Date: 2018
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DOI: 10.1007/s10729-017-9400-z

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