Heterogeneity and event dependence in the analysis of sickness absence
Background Sickness absence (SA) is an important social, economic and public health issue. Identifying and understanding the determinants, whether biological, regulatory or, health services-related, of variability in SA duration is essential for better management of SA. The conditional frailty model...
| Autores: | , , , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2013 |
| País: | España |
| Institución: | Universitat Politècnica de Catalunya (UPC) |
| Repositorio: | UPCommons. Portal del coneixement obert de la UPC |
| Idioma: | inglés |
| OAI Identifier: | oai:upcommons.upc.edu:2117/335892 |
| Acceso en línea: | https://hdl.handle.net/2117/335892 https://dx.doi.org/10.1186/1471-2288-13-114 |
| Access Level: | acceso abierto |
| Palabra clave: | Survival analysis (Biometry) Sickness absence Survival analysis Conditional frailty model Poisson regression Mental disorders Neoplasms Anàlisi de supervivència (Biometria) Àrees temàtiques de la UPC::Matemàtiques i estadística::Aspectes socials |
| Sumario: | Background Sickness absence (SA) is an important social, economic and public health issue. Identifying and understanding the determinants, whether biological, regulatory or, health services-related, of variability in SA duration is essential for better management of SA. The conditional frailty model (CFM) is useful when repeated SA events occur within the same individual, as it allows simultaneous analysis of event dependence and heterogeneity due to unknown, unmeasured, or unmeasurable factors. However, its use may encounter computational limitations when applied to very large data sets, as may frequently occur in the analysis of SA duration. Methods To overcome the computational issue, we propose a Poisson-based conditional frailty model (CFPM) for repeated SA events that accounts for both event dependence and heterogeneity. To demonstrate the usefulness of the model proposed in the SA duration context, we used data from all non-work-related SA episodes that occurred in Catalonia (Spain) in 2007, initiated by either a diagnosis of neoplasm or mental and behavioral disorders. Results As expected, the CFPM results were very similar to those of the CFM for both diagnosis groups. The CPU time for the CFPM was substantially shorter than the CFM. Conclusions The CFPM is an suitable alternative to the CFM in survival analysis with recurrent events, especially with large databases. |
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