A center-level approach to estimating the effect of center characteristics on center outcomes

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

This paper introduces a center-level approach to estimating the effect of center characteristics on outcomes. The proposed method applies to studies where the effect of center characteristics is of primary focus and centers rather than individual patients are entities of interest. Although these studies focus on practices and policies at the center level, it is important to account for the differences in outcomes due to varying patient case-mix. The proposed approach includes two steps. The first step estimates the effect of patient-level characteristics on outcomes so that the variability in patient case-mix can be adjusted prior to estimating the effect of center-level factors. The second step aggregates outcomes (adjusted for patient-level factors) of patients from the same center into a distribution of outcomes representing the response for each center. The outcome distributions are multi-valued responses on which the effects of center-level characteristics are modeled using a symbolic data framework. This method can be used to model the effect of center characteristics on the center-mean outcome as well as the within-center outcome variance. It models the effect of patient characteristics at the patient level and the effect of center characteristics at the center level. The method performs well even when the data come from a classical linear regression model or from a linear mixed effect model. The proposed approach is illustrated using a bone marrow transplant example.

Original languageEnglish (US)
Title of host publicationAssociation for Women in Mathematics Series
PublisherSpringer
Pages301-321
Number of pages21
DOIs
StatePublished - Jan 1 2016

Publication series

NameAssociation for Women in Mathematics Series
Volume6
ISSN (Print)2364-5733
ISSN (Electronic)2364-5741

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Keywords

  • Center analysis
  • Center effect
  • Clustered data
  • Multi-valued data
  • Symbolic data

ASJC Scopus subject areas

  • Mathematics(all)
  • Gender Studies

Cite this

Le-Rademacher, J. (2016). A center-level approach to estimating the effect of center characteristics on center outcomes. In Association for Women in Mathematics Series (pp. 301-321). (Association for Women in Mathematics Series; Vol. 6). Springer. https://doi.org/10.1007/978-3-319-34139-2_14