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Joint Modelling of Survival and Emergency Medical Care Usage in Spanish Insureds Aged 65+

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  • Xavier Piulachs
  • Ramon Alemany
  • Montserrat Guillen

Abstract

Background: We study the longevity and medical resource usage of a large sample of insureds aged 65 years or older drawn from a large health insurance dataset. Yearly counts of each subject's emergency room and ambulance service use and hospital admissions are made. Occurrence of mortality is also monitored. The study aims to capture the simultaneous dependence between their demand for healthcare and survival. Methods: We demonstrate the benefits of taking a joint approach to modelling longitudinal and survival processes by using a large dataset from a Spanish medical mutual company. This contains historical insurance information for 39,137 policyholders aged 65+ (39.5% men and 60.5% women) across the eight-year window of the study. The joint model proposed incorporates information on longitudinal demand for care in a weighted cumulative effect that places greater emphasis on more recent than on past service demand. Results: A strong significant and positive relationship between the exponentially weighted demand for emergency, ambulance and hospital services is found with risk of death (alpha = 1.462, p

Suggested Citation

  • Xavier Piulachs & Ramon Alemany & Montserrat Guillen, 2016. "Joint Modelling of Survival and Emergency Medical Care Usage in Spanish Insureds Aged 65+," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-11, April.
    • Handle: RePEc:plo:pone00:0153234
    DOI: 10.1371/journal.pone.0153234
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