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Analysis of interrupted time series mortality trends: An example to evaluate regionalized perinatal care

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  • Gillings, D.
  • Makuc, D.
  • Siegel, E.

Abstract

Interrupted time series designs are frequently employed to evaluate program impact. Analysis strategies to determine if shifts have occurred are not well known. The case where statistical fluctuations (errors) may be assumed independent is considered, and a segmented regression methodology presented. The method discussed is applied to the assessment of changes in local and state perinatal postneonatal mortality to identify historical trends and will be used to evaluate the impact of the North Carolina Regionalized Perinatal Care Program when seven years of postprogram mortality data become avilable. The perinatal program region is contrasted with a control region to provide a basis for interpretation of differences noted. Relevant segmented regression models provided good fits to the data and highlighted mortality trends over the last 30 years. Considerable racial differences in these trends were identified, particularly for postneonatal mortality. Segmented regression is considered relevant fon the analysis of interrupted time series designs in other applications when errors can be taken to be independent. Thus, the methodology may be regarded as a general statistical tool for evaluation purposes.

Suggested Citation

  • Gillings, D. & Makuc, D. & Siegel, E., 1981. "Analysis of interrupted time series mortality trends: An example to evaluate regionalized perinatal care," American Journal of Public Health, American Public Health Association, vol. 71(1), pages 38-46.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.71.1.38_6
    DOI: 10.2105/AJPH.71.1.38
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    1. Jaime Pinilla & Miguel Negrín, 2021. "Non-Parametric Generalized Additive Models as a Tool for Evaluating Policy Interventions," Mathematics, MDPI, vol. 9(4), pages 1-12, February.
    2. Huseyin Cavusoglu & Tuan Q. Phan & Hasan Cavusoglu & Edoardo M. Airoldi, 2016. "Assessing the Impact of Granular Privacy Controls on Content Sharing and Disclosure on Facebook," Information Systems Research, INFORMS, vol. 27(4), pages 848-879, December.
    3. Katherine Baicker & Theodore Svoronos, 2019. "Testing the Validity of the Single Interrupted Time Series Design," CID Working Papers 364, Center for International Development at Harvard University.
    4. James Veney & James Luckey, 1983. "A comparison of regression and ARIMA models for assessing program effects: An application to the mandated highway speed limit reduction of 1974," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 12(1), pages 83-105, January.
    5. Tianshi Li & Wenli Li & Yuqing Zhao & Jingpei Ma, 2023. "Rationality manipulation during consumer decision-making process: an analysis of Alibaba’s online shopping carnival," Electronic Commerce Research, Springer, vol. 23(1), pages 331-364, March.
    6. Harper, Sam, 2017. "The Great Recession and suicide," OSF Preprints gep3z, Center for Open Science.
    7. Andersson, Karolina & Petzold, Max Gustav & Sonesson, Christian & Lonnroth, Knut & Carlsten, Anders, 2006. "Do policy changes in the pharmaceutical reimbursement schedule affect drug expenditures?: Interrupted time series analysis of cost, volume and cost per volume trends in Sweden 1986-2002," Health Policy, Elsevier, vol. 79(2-3), pages 231-243, December.
    8. Attavanich, Witsanu, 2017. "Impact of the First-Time Car Buyer Program on the Environmental Cost of Air Pollution in Bangkok," MPRA Paper 83170, University Library of Munich, Germany.
    9. Michael Miller & C. Stokes & Rex Warland, 1988. "The effect of legalization and public funding of abortion on neonatal mortality: An intervention analysis," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 7(1), pages 79-92, January.
    10. Marvin B. Mandell, 1987. "Obtaining Interval Estimates of Policy Impacts From Interrupted Time Series," Evaluation Review, , vol. 11(5), pages 631-659, October.
    11. Paraje, Guillermo & Colchero, Arantxa & Wlasiuk, Juan Marcos & Sota, Antonio Martner & Popkin, Barry M., 2021. "The effects of the Chilean food policy package on aggregate employment and real wages," Food Policy, Elsevier, vol. 100(C).
    12. Marvin B. Mandell, 1986. "The Effect of Regionalization On Infant and Early Neonatal Mortality," Evaluation Review, , vol. 10(6), pages 806-829, December.
    13. Roya Daneshmand & Shreedhar Acharya & Barbara Zelek & Michael Cotterill & Brianne Wood, 2023. "Changes in Children and Youth’s Mental Health Presentations during COVID-19: A Study of Primary Care Practices in Northern Ontario, Canada," IJERPH, MDPI, vol. 20(16), pages 1-12, August.
    14. Katherine Baicker & Theodore Svoronos, 2019. "Testing the Validity of the Single Interrupted Time Series Design," NBER Working Papers 26080, National Bureau of Economic Research, Inc.
    15. Marco D. Huesch & Truls Østbye & Michael K. Ong, 2012. "Measuring The Effect Of Policy Interventions At The Population Level: Some Methodological Concerns," Health Economics, John Wiley & Sons, Ltd., vol. 21(10), pages 1234-1249, October.

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