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Results for “Event History Analysis”

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PubMed2005

Psychiatric hospitalisation and suicide among the very old in Denmark: population-based register study.

BACKGROUND: Very old people have higher suicide rates than the younger elderly population. Psychiatric disorders are known to have a strong association with suicide among elderly people. AIMS: To analyse the analyse the suicide risk associated with psychiatric hospitalisation among the very old (> or =80 years) compared with the middle-aged (50-64 years) and old (65-79 years) populations. METHOD: Individual-level data on the entire Danish population aged 50 years or over were analysed for the period 1994-1998. Relative suicide risks were calculated using event-history analysis. RESULTS: Among 1978 527 persons, 2323 died by suicide. Although the very old group exhibited a four-fold to five-fold increase in risk of suicide for those previously hospitalised, we noted an inverse interaction effect: the increase is distinctly smaller compared with that in the middle-aged and old groups. CONCLUSIONS: The association between suicide and psychiatric hospitalisation is much weaker for the very old than for the old. Psychiatric disorders among very old people may be interacting with other disorders, may be underdiagnosed or treated in other healthcare settings.

Age Factors↗
PubMed1997

Cost savings from home and community-based services: Arizona's capitated Medicaid long-term care program.

The Arizona Long-Term Care System is the first capitated, long-term care Medicaid program in the nation to operate statewide. It promotes an extensive home and community-based services program intended to lower long-term care costs by substituting home care for institutional care. Because the program is statewide, finding a suitable control group to evaluate it was a serious problem. A substitute strategy was chosen that compares actual costs incurred to an estimate of what costs would have been in the absence of home and community-based (HCB) services. To estimate the likelihood of institutionalizing clients in the absence of HCB services, coefficients for institutionalization risk factors were estimated in a logistic regression model developed using national data. These were applied to characteristics of Arizona clients. The model assigned approximately 75 percent of the program's clients to a category with traits that were determined to resemble nursing home residents' traits. A similar methodology was used to estimate lengths of nursing home stays. Lengths of stay by the program's nursing home patients were regressed on their characteristics using an event history analysis model. Coefficients for these characteristics from the regression analysis were then applied to HCB services clients to estimate how long their nursing home stays would have lasted, had they been institutionalized. These estimated nursing home stays were generally shorter than these same patients' observed home and community stays. Risk of institutionalization was then multiplied by estimated length of stay and by monthly nursing home costs to estimate what costs would have been without the HCB services option. The expected costs were compared to actual costs to judge cost savings. Home and community-based services appeared to save substantial amounts on costs of nursing home care. Estimates of savings were very robust and did not appear to be declining as the program matured. Savings probably came from several sources: the assessment teams that judged client eligibility were employed by a state agency and thus were independent from the program contractors; clients were required to be in need of at least a three-month nursing home stay; a cap was placed on the number of HCB services clients contractors were allowed to serve each month; the capitated payment methodology forced managed care contractors to hold down average HCB services costs or lose money; and the HCB services and nursing home costs were blended in the capitated rate, so that plans that failed to place clients in HCB services would lose money by using more nursing home days than their monthly capitated rate allowed.

Arizona↗
PubMed2004

Sex and experience in the academy award nomination process.

Research has indicated significant age differences between male and female Academy Award nominees and winners. However, this discrepancy may be associated with sex differences in actors' ages when they first begin their acting careers. The present research uses event history analysis to investigate the duration of Academy Award nominees' careers from career start (first film) to first three Academy Award nominations. Analysis suggested controlling for an actor's age at first film explains the sex-age disparity between Academy Award nominees and winners.

Academies and Institutes↗
PubMed1999

Incidence and duration of hospitalizations among persons with AIDS: an event history approach.

OBJECTIVE: To analyze hospitalization patterns of persons with AIDS (PWAs) in a multi-state/multi-episode continuous time duration framework. DATA SOURCES: PWAs on Medicaid identified through a match between the state's AIDS Registry and Medicaid eligibility files; hospital admission and discharge dates identified through Medicaid claims. STUDY DESIGN: Using a Weibull event history framework, we model the hazard of transition between hospitalized and community spells, incorporating the competing risk of death in each of these states. Simulations are used to translate these parameters into readily interpretable estimates of length of stay, the probability that a hospitalization will end in death, and the probability that a nonhospitalized person will be hospitalized within 90 days. PRINCIPAL FINDINGS: In multivariate analyses, participation in a Medicaid waiver program offering case management and home care was associated with hospital stays 1.3 days shorter than for nonparticipants. African American race and Hispanic ethnicity were associated with hospital stays 1.2 days and 1.0 day longer than for non-Hispanic whites; African Americans also experienced more frequent hospital admissions. Residents of the high-HIV-prevalence area of the state had more frequent admissions and stays two days longer than those residing elsewhere in the state. Older PWAs experienced less frequent hospital admissions but longer stays, with hospitalizations of 55-year-olds lasting 8.25 days longer than those of 25-year-olds. CONCLUSIONS: Much socioeconomic and geographic variability exists both in the incidence and in the duration of hospitalization among persons with AIDS in New Jersey. Event history analysis provides a useful statistical framework for analysis of these variations, deals appropriately with data in which duration of observation varies from individual to individual, and permits the competing risk of death to be incorporated into the model. Transition models of this type have broad applicability in modeling the risk and duration of hospitalization in chronic illnesses.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Gender and the socioeconomic gradient in mortality.

Despite considerable evidence documenting a strong and persistent relationship between socioeconomic position and mortality, recent research suggests that this association may be weaker among women. In our examination of gender differences in the socioeconomic gradient in mortality, we argue that this inconsistency arises from the failure to consider the ways in which gender is a fundamental constituent of socioeconomic position. The data used are from the Panel Study of Income Dynamics. Respondents, including all household heads and their partners, aged 29 years and older in 1972 (N = 5,665; 56% female), were followed until 1991, death, or attrition. Discrete time event history analysis was used to examine the predictors of death between 1972 and 1991. Of the key socioeconomic predictors, years of education was measured at baseline, while earned income was a time-varying covariate. We find no gender differences in the effect of respondents' own socioeconomic positions on their mortality risk. However, increasing spousal income raises men's odds of dying, while the opposite is true for women. Our results raise questions about the prevailing view that the socioeconomic gradient in mortality is weaker among women. Moreover, gender differences in the effects of spousal earnings on mortality risk suggest that their labor market rewards have fundamentally different meanings for women and men.

Adult↗
PubMed1999

[Active life expectancy in Germany].

Using the method of multistate life-tables, the article presents results on active life expectancy on the basis of the German Socio-Economic Panel Survey (SOEP). Different determinants of mortality and morbidity are revealed by event-history analysis. Results show that men live a greater proportion of their lives without disability than do women. Results on the association between mortality/morbidity and socio-economic factors suggest that studies which usually focussed either on mortality or on morbidity cannot fully explain differences in active life expectancy.

Adult↗
PubMed2001

Organizational adoption of preemployment drug testing.

This study explored the adoption of preemployment drug testing by 360 organizations. Survival models were developed that included internal organizational and labor market factors hypothesized to affect the likelihood of adoption of drug testing. Also considered was another set of variables that included social and political variables based on institutional theory. An event history analysis using Cox regressions indicated that both internal organizational and environmental variables predicted adoption of drug testing. Results indicate that the higher the proportion of drug testers in the worksite's industry, the more likely it would be to adopt drug testing. Also, the extent to which an organization uses an internal labor market, voluntary turnover rate, and the extent to which management perceives drugs to be a problem were related to likelihood of adoption of drug testing.

Adult↗
PubMed1994

[Commuting versus moving? Choice and stability in place of residence versus place of work].

"The development of internal migration in the Federal Republic of Germany during the last few decades shows that commuting is becoming more and more a substitute for moves over long distances.... This paper tries to explain this 'mobility transition' by means of a model of individual choice between commuting and moving. The model is also able to account for changes in structural components. The decision-model is empirically tested by using methods of event history analysis with the data of the Socio-Economic Panel." (SUMMARY IN ENG)

Behavior↗
PubMed1989

[The expansion of the educational system and the birth decline in the Federal Republic of Germany: a cohort-based simulation on the impact of the changing educational structure on reproductive behavior].

"Demographic studies on cohort fertility have revealed that the birth decline in the [Federal Republic of Germany] was accompanied or even brought about by a considerable postponement in parenthood. By means of event history analysis and micro-simulation this article shows that the postponement of motherhood can be attributed to the expansion of the educational system that took place in the 60s and early 70s. Furthermore, changes in educational structure have contributed markedly to increased childlessness in the younger generation, whereas there is no relation between the reduction in family size and the structural changes in education. The impact of increased education on the family life-cycle can be explained by labour market theories, whereas traditional theories have neglected biographic aspects of fertility." (SUMMARY IN ENG)

Cohort Studies↗
PubMedDate not supplied

Changing nuptiality patterns in contemporary Spain.

"This paper describes recent nuptiality trends [in Spain] and explores some socio-demographic factors that influence marital timing. Event history analysis is applied to retrospective marital histories collected in the 1985 Spanish National Survey of Fertility. Discrete hazard models are used in order to capture the changing dynamics of the nuptiality process throughout the age range. The results indicate that a trend towards late marriage has evolved in Spain during the last decade, without a concomitant rise in nonmarital cohabitation. The pattern of marriage postponement is especially pronounced among women residing in urban areas and those better educated." (SUMMARY IN ITA)

Demography↗
PubMed1992

Drug use as a risk factor for premarital teen pregnancy and abortion in a national sample of young white women.

The relationship between adolescent drug use and premarital teen pregnancy and abortion as a pregnancy outcome among sexually active women is investigated in a sample of white women from the National Longitudinal Survey of Youth. Event history analysis is used to explore whether prior drug use has a unique effect on premarital teen pregnancy, with controls for personality, lifestyle, and biological factors. Logistic regression is used to estimate whether drug use affects the decision to terminate a premarital teen pregnancy. The results show that the risk of premarital teen pregnancy is nearly four times as high for those who have used illicit drugs other than marijuana as for those with no history of any prior substance involvement. Furthermore, illicit drug use increases the likelihood of an abortion by a factor of 5. Policy implications of the findings are discussed.

Abortion, Induced↗
PubMed1999

[Survival analysis example based on an event history model from a clinical trial in cardiology].

BACKGROUND: The main purpose of this paper is to present a survival analysis example based on an event history model in a competitive risks framework. Our example is derived from a clinical trial designed for comparing survival of a beta-blocker therapy group and a placebo group. METHODS: Competitive risks under study were non lethal cardiovascular events, permanent treatment withdrawals and deaths. The event history model was assumed to be semi-Markovian. The Cox proportional hazards model was used for modeling effects of treatments and regression variables on the transition rates. RESULTS: After taking into account all covariables influencing survival, mortality in patients who had one non lethal cardiovascular event after randomization but remained treated was shown to be reduced in the beta-blocker therapy group (RR=0.41; CI 95%=[0.17-0.98], p=0.04). CONCLUSIONS: Our analysis indicates that beta-blocker therapy should not necessarily be stopped in patients who experience a non lethal cardiovascular event under treatment. This finding requires confirmation in a separate setting.

Heart Diseases↗
PubMed1996

Analysing home-ownership of couples: the effect of selecting couples at the time of the survey.

"The analysis of events encountered by couple and family households may suffer from sample selection bias when data are restricted to couples existing at the moment of interview. The paper discusses the effect of sample selection bias on event history analyses of buying a home [in the Netherlands] by comparing analyses performed on a sample of existing couples with analyses of a more complete sample including past as well as current partner relationships. The results show that, although home-buying in relationships that have ended differs clearly from behaviour in existing relationships, sample selection bias is not alarmingly large." (SUMMARY IN FRE)

Bias↗
PubMed1995

Do you need to shop around? Age at marriage, spousal alternatives, and marital dissolution.

"This article attempts to shed light on the oft-observed relationship between age at marriage and marital dissolution by first deriving a hypothesis from marital search theory that relates both variables to the supply of spousal alternatives in the local marriage market. This hypothesis states that, relative to people who marry later in life, persons who marry at comparatively young ages will be especially susceptible to divorce when confronted with abundant alternatives to their current spouse. Marital history data from the National Longitudinal Survey of Youth were then merged with aggregated data from the Public Use Microdata Samples of the 1980 U.S. census to test this hypothesis." The author finds that "discrete-time event history analyses offer no support for this hypothesis. Although the risk of marital dissolution is highest where either husbands or wives chance numerous spousal alternatives, the impact of age at marriage on divorce is significantly weaker in marriage markets containing abundant remarriage opportunities. Some of the effect of age at marriage on marital dissolution is attributable to the detrimental impact of early marriage on educational attainment."

Americas↗
PubMed1998

The impact of consanguinity and inbreeding on perinatal mortality in Karachi, Pakistan.

Close consanguineous unions continue to be extremely common in much of West Asia, including Pakistan. However, the impact of inbreeding on offspring mortality, particularly perinatal mortality, remains poorly documented. This paper attempts to measure the mortality risks associated with consanguinity and inbreeding while controlling for the effects of other potential confounders. The study sample comprises a multi-ethnic population residing in selected squatter settlements of Karachi. The adjusted odds ratio for perinatal mortality in the offspring of women married to their first cousins was 2.0 [95% CI 1.5, 2.6]. When parental inbreeding was also taken into account, the adjusted odds ratio for perinatal mortality increased further. Analysis of a subsample of data limited to pregnancies to women aged 35 years or above (at the time of the survey) showed that, despite adjustment for important biological and socio-demographic factors, both consanguinity and inbreeding remained important predictors of perinatal mortality in the offspring. Implications of the present study for further research are highlighted.

Adolescent↗