Using Log-Linear Models and Odd Ratios to Determine Outcome of Admissions in a Hospital
Downloads
The purpose of this study is to determine the outcome of patients’ admission in the medical ward (male, female and paediatrics) in the Central Regional Hospital
The specific objectives of the study are as follows:to determine association between Outcome of admission(alive and death), Year of admission conditioning on the type of Medical Ward, to determine association between Medical Ward and Outcome of admission(alive and death) conditioning Year of admission, to determine association between Year of admission, Medical Ward and Outcome of admission(alive and death) and determine associations among variables by means of log-linear model Statistics and likelihood ratios
The statistical tools used in analyzing the data were SPSS Micro soft excel and SAS. The Outcome of admission variable was categories into two levels; the medical ward had three levels and year variable had five levels and is ordinal. The model approach based on log-linear models was used. In this case, the homogeneous association was tested by comparing the saturated model (SM) and a model assuming homogeneity (HAM). The conditional independence was checked by comparing the HAM model with different models assuming conditional independence. The best model was chosen to conduct further analysis on the effect of medical ward on the outcome of admission while controlling by year.
It realized that total number of patients admitted in the hospital was twelve thousand four hundred and twenty six (12426) for the 5 year period. Ten thousand seven hundred and sixty one (10761) were discharged (alive); representing 86.6%. Also one thousand six hundred and sixty five died; representing 13.4% for the same five year period.
We observed that the female medical ward recorded highest patients’ death in the hospital from 2006 to 2010.
In this model, the conditional likelihood ratio between any two variable are identical. We therefore concluded that the best model is the saturated log-linear model.
Agresti, A (1996). An Introduction to Categorical Data Analysis. John Wiley & Sons, Inc. New York, New York, USA. and Outcome in Acute Myocardial Infarction and Outcome in Acute Myocardial Infarction - IMAJ . Vol 5 . Angela Jeansonne (2002) log-linear models
Antwi, K.B. (2008) Stakeholders Perception of Current Health Education Situation
Ashton, C. M. and Wray, N. P. (1996). A conceptual framework for the study of early readmission as an indicator of quality of care. Soc.Sci.Med. 43, 1533-1541.
Beck, E. J., Ehrmann, F. D., Thivierge, C., Guérard, L., & Déry, V. (2000) The need and feasibility of a prospective monitoring system for chronic hea(rt failure in Montréal : SurvICe. Montreal: Direction de la santé publique, Régierégionale de la santé et des services sociaux de Montréal-Centre.
Brook, R.H., Kahn, K. L., & Kosecoff, J. (1992). Assessing clinical instability at discharge: The clinician's responsibility. JAMA 268, 1321-1322.
Burns, R.B., McCarthy, E.P., Moskowitz, M.A., Ash, A., Kane, R.L., & Finch, M. (1997) Outcomes for older men and women with congestive heart failure. J Am GeriatrSoc 1997; 45:276-80.
Cleland, J. G. F., Gemmell, I., Khand, A., & Boddy, A. (1999). Is the prognosis of heart failure improving? Eur. J. Heart Fail; 1:229-41.
Cordle, F., & Tyroler, H. A. (1974). The use of Hospital medical records for epidemiologic research. Differences in Hospital Utilization and in hospital mortality by age- race-sex- place of residence and socioeconomic status in a defined community population. Medical care; 12: 596-610.
Dean, M. P.G., Gear, J. S. S. Medical admissions to Hillbrow Hospital, Johannesburg, by discharge diagnosis. S Afr Med J. 1986;69: 672-3.
Debbie, E., Feldman, C. T., Lise Guérard,(2001) Trends in Mortality andAdmissions in Hospitals
Denise, C. (2009). Admission and Discharge of Patients from Hospital and Residential Settings Policy October No: CLIN/0012/v4
Feldman, D.E. (2001) changing trends in mortality and admissions to hospital
Leng, G.C., Walsh, D., Fowkes, F.G.R., & Swainson, C.P. (1999). Quality in Health Care, 8:234–238
G. Amit et al. (2003) the Association between Hospital Department, Medical Treatment .IMAJ Vol 5.
Garko, S.B., Ekweani, C.N., & Anyiam, C.A. (2003). Duration of Hospital stay and Mortality in the medical wards of Ahmadu Bello University Teaching Hospital, Kaduna, Nigera. Annals of African Medicine, 2(2), 68-71.
Glasgow, Weissberg, et al. (1991). Readmissions of children with diabetes mellitus to a children's hospital. Pediatrics 88, 98-104.
Goff, D. C., Pandy. D. K. K., Chan, F. A., Ortiz, C., & Nichaman, M. Z. (2000) Congestive heart failure in the United States : Is there more than meets the I(CD Code)? The Corpus Christi Heart Project. Arch Intern Med;160:197-202.
Graves, E. J. Detailed diagnoses and procedures: National Hospital Discharge Survey, 1989. Vital Health Stat 13 1991; Sept(108):1-236.
Gregg, C., Fonarow, M. D, & Ahmanson (2008). Day of Admission and Clinical Outcomes for Patients Hospitalized for Heart Failure.
Guy Amit, M. D., Sylvie Goldman, M. D., Liora Ore, M. D., Marcelo Low, M. P. H., Jeremy, D., & Kark, M. D. (2003). The Association between Hospital Department, Medical Treatment.
Habte –Gabr, E., Girma, B., Mehrete, M., Mehari, A., Tekle, E., & Belachew, K. (1976) Analysis of Admissions to Gondar Hospital in NorthWestern Ethiopia, Ethiop Med J.; 14:49-59.
Hayward, R. A., Bernard, A. M., Rosevear, J. S., Anderson, J. E., & McMahon-L. F. J. (1993). An evaluation of generic screens for poor quality of hospital care on a general medicine service .Med.Care31, 394-402.
Herlitz, J., Bengtson, A., Hjalmarson, A., & Karlson, B. W. (1988). Morbidity during five years after myocardial infarction and its relation to infarct size. Clin.Cardiol. 11, 672-677.
http://asio.jde.aca.mmu.ac.uk/new_gis/analysis/loglin.htm- A brief tutorial on log-linear models. (retrieved April 15, 2018).
http://wizard.ucr.edu/~rhannema/soc203a/loglin.html- A comprehensive article on hierarchical log-linear models. Retrieved April 15, 2018
http://www.math.yorku.ca/SCS/Courses/grcat/grc8.html- A brief discussion on log linear models and how to use the statistical software, SAS, for log linear modeling. (retrieved April15, 2018).
http://www.statsoftinc.com/textbook/stloglin.html- A tutorial on log-linear analysis of frequency tables. Retrieved April 15, 2018
http://www2.chass.ncsu.edu/garson/pa765/logit.htm- A brief tutorial on log-linear, logit and probit models. (retrieved April 15, 2018).
Huffman (1990) Medical Records Manual. A Guide for Developing Countries
Hussein, K. (1997). Pattern of Medical Admissions to Jimma Hospital. Bull Inst Health Sci.;7(1): 51-62.
Knoke, D., & Burke, P. J. (1980). Log-Linear Models. Sage Publications, Inc. Newberry Park, California, USA.
Kolo, P. M., & Chijioke Adindu. (2010). Gender Disparities among Medical Admissions of a tertiary health facility IIoroin. Nigeria.
Medical Records Manual A Guide for Developing Countries (World Health Organization 2002)
Rich MW. (1999) Heart failure disease management: a critical review. J Card Fail; 5:64-75.
Taylor, I. C., & McConnell, J. G. (1995) Patterns of admission and discharge in an acute geriatric userwww.sfsu.edu/~efc/.../Log%20Linear%20Models.htm
All Content should be original and unpublished.
