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Modelling the neonatal system: A joint analysis of length of stay and patient pathways

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  • Shola Adeyemi
  • Eren Demir

Abstract

In the United Kingdom, one in seven babies require specialist neonatal care after birth, with a noticeable increase in demand. Coupled with budgeting constraints and lack of investment means that neonatal units are struggling. This will inevitably have an impact on baby's length of stay (LoS) and the performance of the service. Models have previously been developed to capture individual babies' pathways to investigate the longitudinal cycle of care. However, no models have been developed to examine the joint analysis of LoS and babies' pathways. LoS at each stage of care is a critical driver of both the clinical outcomes and economic performance of the neonatal system. Using the generalized linear mixed modelling approach, extended to accommodate multiple outcomes, the association between neonate's pathway to discharge and LoS is examined. Using the data about 1002 neonates, we noticed that there is a high positive association between baby's pathway and total LoS, suggesting that discharge policies needs to be looked at more carefully. A novel statistical approach that examined the association of key outcomes and how it evolved over time is developed. Its applicability can be extended to other types of long‐term care or diseases, such as heart failure and stroke.

Suggested Citation

  • Shola Adeyemi & Eren Demir, 2020. "Modelling the neonatal system: A joint analysis of length of stay and patient pathways," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(3), pages 704-717, May.
    • Handle: RePEc:bla:ijhplm:v:35:y:2020:i:3:p:704-717
    DOI: 10.1002/hpm.2928
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    References listed on IDEAS

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    1. Shola Adeyemi & Thierry Chaussalet & Haifeng Xie & Md Asaduzaman, 2010. "Random effects models for operational patient pathways," Journal of Applied Statistics, Taylor & Francis Journals, vol. 37(4), pages 691-701.
    2. Eren Demir & Reda Lebcir & Shola Adeyemi, 2014. "Modelling length of stay and patient flows: methodological case studies from the UK neonatal care services," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 65(4), pages 532-545, April.
    3. Shola Adeyemi & Thierry Chaussalet & Eren Demir, 2011. "Nonproportional random effects modelling of a neonatal unit operational patient pathways," Statistical Methods & Applications, Springer;Società Italiana di Statistica, vol. 20(4), pages 507-518, November.
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