A continuous time Markov model for the length of stay of elderly people in institutional long-term care

Xie, H., Chaussalet, T.J. and Millard, P.H. 2005. A continuous time Markov model for the length of stay of elderly people in institutional long-term care. Journal of the Royal Statistical Society: Series A. 168 (1), pp. 51-61. https://doi.org/10.1111/j.1467-985X.2004.00335.x

TitleA continuous time Markov model for the length of stay of elderly people in institutional long-term care
AuthorsXie, H., Chaussalet, T.J. and Millard, P.H.
Abstract

The paper develops a Markov model in continuous time for the length of stay of elderly people moving within and between residential home care and nursing home care. A procedure to determine the structure of the model and to estimate parameters by maximum likelihood is presented. The modelling approach was applied to 4 years' placement data from the social services department of a London borough. The results in this London borough suggest that, for residential home care, a single-exponential distribution with mean 923 days is adequate to provide a good description of the pattern of the length of stay, whereas, for nursing home care, a mixed exponential distribution with means 59 days (short stay) and 784 days (long stay) is required, and that 64% of admissions to nursing home care will become long-stay residents. The implications of these findings and the advantages of the proposed modelling approach in the general context of long-term care are discussed.

JournalJournal of the Royal Statistical Society: Series A
Journal citation168 (1), pp. 51-61
ISSN0964-1998
YearJan 2005
Digital Object Identifier (DOI)https://doi.org/10.1111/j.1467-985X.2004.00335.x
Web address (URL)http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1467-985X.2004.00335.x
Publication dates
PublishedJan 2005

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Data warehousing based architecture for the reporting of the NHS primary care prescribing
Redzanovic, S., Chountas, P., Chaussalet, T.J., Fouladinejad, F., Tadjer, M. and Fouladinajed, F. 2011. Data warehousing based architecture for the reporting of the NHS primary care prescribing. in: Olive, M. and Solomonides, T. (ed.) Proceedings of CMBS: the 24th International Symposium on Computer-Based Medical Systems, June 27th – 30th, 2011, Bristol, United Kingdom IEEE .

Exploring the effect of temperature variations on unplanned asthma admissions
Islam, M.S., Chaussalet, T.J., Balta-Ozkan, N. and Demir, E. 2011. Exploring the effect of temperature variations on unplanned asthma admissions. in: Operational Research Information National Health Policy: proceedings of the 37th ORAHS conference School of Mathematics, Cardiff University. pp. 74-88

The impact of temperature disparity on emergency readmissions and patient flows
Islam, M.S., Chaussalet, T.J., Balta-Ozkan, N., Chahed, S., Demir, E. and Sarran, C. 2011. The impact of temperature disparity on emergency readmissions and patient flows. in: Olive, M. and Solomonides, T. (ed.) Proceedings of CMBS: the 24th International Symposium on Computer-Based Medical Systems, June 27th – 30th, 2011, Bristol, United Kingdom IEEE .

Modelling high dependency care in the local neonatal unit
Dalton, S. and Chaussalet, T.J. 2011. Modelling high dependency care in the local neonatal unit. in: Operational Research Information National Health Policy: proceedings of the 37th ORAHS conference Cardiff School of Mathematics, Cardiff University.

Nonproportional random effects modelling of a neonatal unit operational patient pathways
Adeyemi, S., Chaussalet, T.J. and Demir, E. 2011. Nonproportional random effects modelling of a neonatal unit operational patient pathways. Statistical Methods and Applications. 20 (4), pp. 507-518. https://doi.org/10.1007/s10260-011-0174-z

Measuring and modelling occupancy time in NHS continuing healthcare
Chahed, S., Demir, E., Chaussalet, T.J., Millard, P.H. and Toffa, S.E. 2011. Measuring and modelling occupancy time in NHS continuing healthcare. BMC Health Services Research. 11 (155), p. 1. https://doi.org/10.1186/1472-6963-11-155

Editorial: IMA Health 2010
Vasilakis, C., Chaussalet, T.J. and Baker, R.D. 2011. Editorial: IMA Health 2010. Health Care Management Science. 14 (3), pp. 213-214. https://doi.org/10.1007/s10729-011-9174-7

A loss network model with overflow for capacity planning of a neonatal unit
Asaduzzaman, M., Chaussalet, T.J. and Robertson, N.J. 2010. A loss network model with overflow for capacity planning of a neonatal unit. Annals of Operations Research. 178 (1), pp. 67-76. https://doi.org/10.1007/s10479-009-0548-x

Random effects models for operational patient pathways
Adeyemi, S., Chaussalet, T.J., Xie, H. and Assaduzzman, M. 2010. Random effects models for operational patient pathways. Journal of Applied Statistics. 37 (4), pp. 691-701. https://doi.org/10.1080/02664760902873951

Analysis of variability in neonatal care units: a retrospective analysis
Adeyemi, S., Demir, E., Chahed, S. and Chaussalet, T.J. 2010. Analysis of variability in neonatal care units: a retrospective analysis. in: IEEE Workshop on Health Care Management (WHCM), Venice, 18-20 February 2010 IEEE . pp. 1-6

Towards effective capacity planning in a perinatal network centre
Asaduzzaman, M., Chaussalet, T.J., Adeyemi, S., Chahed, S., Hawdon, J., Wood, D. and Robertson, N.J. 2010. Towards effective capacity planning in a perinatal network centre. Archives of Disease in Childhood. Fetal and Neonatal Edition. 95 (4), pp. F283-F287. https://doi.org/10.1136/adc.2009.161661

Clustering patient length of stay using mixtures of Gaussian models and phase type distributions
Garg, L., McClean, S.I., Meenan, B., El-Darzi, E. and Millard, P.H. 2009. Clustering patient length of stay using mixtures of Gaussian models and phase type distributions. in: Proceedings of the 22nd IEEE International Symposium on Computer-Based Medical Systems (CBMS 2009) IEEE . pp. 1-7

Length of stay-based clustering methods for patient grouping
El-Darzi, E., Abbi, R., Vasilakis, C., Gorunescu, F., Gorunescu, M. and Millard, P.H. 2009. Length of stay-based clustering methods for patient grouping. in: McClean, S.I., Millard, P.H., El-Darzi, E. and Nugent, C. (ed.) Intelligent patient management Berlin Heidelberg Springer.

A Grid implementation for profiling hospitals based on patient readmissions
Demir, E., Chaussalet, T.J., Weingarten, N. and Kiss, T. 2009. A Grid implementation for profiling hospitals based on patient readmissions. in: McClean, S.I., Millard, P.H., El-Darzi, E. and Nugent, C. (ed.) Intelligent patient management Springer.

A systematic approach in defining readmission
Demir, E. and Chaussalet, T.J. 2009. A systematic approach in defining readmission. in: Proceedings of the 22nd IEEE International Symposium on Computer-Based Medical Systems (CBMS 2009) IEEE . pp. 1-7

The analyses of individual patient pathways: investigating regional variation in COPD readmissions
Adeyemi, S., Chaussalet, T.J., Xie, H. and Asaduzzaman, M. 2009. The analyses of individual patient pathways: investigating regional variation in COPD readmissions. in: Sakalauskas, L., Skiadas, C. and Zavadskas, E.K. (ed.) Proceedings of the 13th International Conference "Applied Stochastic Models and Data Analysis", ASMDA 2009, 30 June – 3 July 2009, Vilnius, Lithuania ASMDA. pp. 316-319

Models for extracting information on patient pathways
Adeyemi, S. and Chaussalet, T.J. 2009. Models for extracting information on patient pathways. in: McClean, S.I., Millard, P.H., El-Darzi, E. and Nugent, C. (ed.) Intelligent patient management Springer.

Editorial: Applying mathematics to problems in health care: a call to pencils
Utley, M., Chaussalet, T.J. and Baker, R.D. 2009. Editorial: Applying mathematics to problems in health care: a call to pencils. IMA Journal of Management Mathematics. 20 (4), pp. 323-323. https://doi.org/10.1093/imaman/dpn036

Modelling risk of readmission with phase-type distribution and transition models
Demir, E., Chaussalet, T.J., Xie, H. and Millard, P.H. 2009. Modelling risk of readmission with phase-type distribution and transition models. IMA Journal of Management Mathematics. 20 (4), pp. 357-367. https://doi.org/10.1093/imaman/dpn032

Emergency readmission criterion: a technique for determining emergency readmission time window
Demir, E., Chaussalet, T.J., Xie, H. and Millard, P.H. 2008. Emergency readmission criterion: a technique for determining emergency readmission time window. IEEE Transactions on Information Technology in Biomedicine. 12 (5), pp. 644-649. https://doi.org/10.1109/TITB.2007.911311

Modelling and performance measure of a perinatal network centre in the United Kingdom
Asaduzzaman, M. and Chaussalet, T.J. 2008. Modelling and performance measure of a perinatal network centre in the United Kingdom. in: Proceedings of the 21st IEEE International Symposium on Computer-Based Medical Systems, IEEE CBMS 2008, Jyväskylä, 17-19 June 2008 Los Alamitos, USA IEEE . pp. 506-511

A random effects sensitivity analysis for patient pathways model
Adeyemi, S. and Chaussalet, T.J. 2008. A random effects sensitivity analysis for patient pathways model. in: Proceedings of the 21st IEEE International Symposium on Computer-Based Medical Systems, IEEE CBMS 2008, Jyväskylä, 17-19 June 2008 Los Alamitos, USA IEEE . pp. 536-538

Length of stay based grouping and classification methodology for modelling patient flow
Abbi, R., El-Darzi, E., Vasilakis, C. and Millard, P.H. 2008. Length of stay based grouping and classification methodology for modelling patient flow. Journal of Operations and Logisitics. 2 (2), pp. 1-9.

A Gaussian mixture model approach to grouping patients according to their hospital length of stay
Abbi, R., El-Darzi, E., Vasilakis, C. and Millard, P.H. 2008. A Gaussian mixture model approach to grouping patients according to their hospital length of stay. in: Proceedings of the 21st IEEE International Symposium on Computer-Based Medical Systems (CBMS '08) IEEE . pp. 524-529

Analysis of stopping criteria for the EM algorithm in the context of patient grouping according to length of stay
Abbi, R., El-Darzi, E., Vasilakis, C. and Millard, P.H. 2008. Analysis of stopping criteria for the EM algorithm in the context of patient grouping according to length of stay. in: Proceedings of the 4th International IEEE Conference on Intelligent Systems IS'08. Varna, Bulgaria, September, 6-8 2008 Los Alamitos, USA IEEE .

Balancing the NHS balanced scorecard!
Patel, B., Chaussalet, T.J. and Millard, P.H. 2008. Balancing the NHS balanced scorecard! European Journal of Operational Research. 185 (3), pp. 905-914. https://doi.org/10.1016/j.ejor.2006.02.056

Editorial: IMA Health 2007
Baker, R.D., Chaussalet, T.J. and Utley, M. 2008. Editorial: IMA Health 2007. Health Care Management Science. 11 (2), pp. 87-88. https://doi.org/10.1007/s10729-008-9065-8

Where to treat the older patient? Can Markov models help us better understand the relationship between hospital and community care?
McClean, S.I. and Millard, P.H. 2007. Where to treat the older patient? Can Markov models help us better understand the relationship between hospital and community care? Journal of the Operational Research Society. 58 (2), pp. 255-261. https://doi.org/10.1057/palgrave.jors.2602173

An objective method for bed capacity planning in a hospital department - a comparison with target ratio methods.
Nguyen, J.M., Six, P., Chaussalet, T.J., Antonioli, D., Lombrail, P. and Le Beux, P. 2007. An objective method for bed capacity planning in a hospital department - a comparison with target ratio methods. Methods of Information in Medicine. 46 (4), pp. 399-405. https://doi.org/10.1160/me0385

A semi-open queueing network approach to the analysis of patient flow in healthcare systems
Xie, H., Chaussalet, T.J. and Rees, M. 2007. A semi-open queueing network approach to the analysis of patient flow in healthcare systems. in: Proceedings of the 20th IEEE International Symposium on Computer-Based Medical Systems. IEEE CBMS 2007, Maribor, Slovenia, 20-22 June 2007 Los Alamitos, USA IEEE . pp. 719-724

Determining readmission time window using mixture of generalised Erlang distribution
Demir, E., Chaussalet, T.J. and Xie, H. 2007. Determining readmission time window using mixture of generalised Erlang distribution. in: Proceedings of the 20th IEEE International Symposium on Computer-Based Medical Systems. IEEE CBMS 2007, Maribor, Slovenia, 20-22 June 2007 Los Alamitos, USA IEEE . pp. 21-26

Developing an application of an accident and emergency patient simulation modelling using an interactive framework
Codrington-Virtue, A., Chaussalet, T.J., Whittlestone, P. and Kelly, J. 2007. Developing an application of an accident and emergency patient simulation modelling using an interactive framework. in: Brailsford, S. and Harper, P.R. (ed.) Operational research for health policy: making better decisions: proceedings of the 31st Annual Conference of the European Working Group on Operational Research Applied to Health Services Oxford ; New York Peter Lang. pp. 61-76

Patients flow: a mixed-effects modelling approach to predicting discharge probabilities
Adeyemi, S., Chaussalet, T.J., Xie, H. and Millard, P.H. 2007. Patients flow: a mixed-effects modelling approach to predicting discharge probabilities. in: Proceedings of the 20th IEEE International Symposium on Computer-Based Medical Systems. IEEE CBMS 2007, Maribor, Slovenia, 20-22 June 2007 Los Alamitos, USA IEEE . pp. 725-730

A simple graphical decision aid for the placement of elderly people in long-term care
Xie, H., Chaussalet, T.J., Thompson, W.A. and Millard, P.H. 2007. A simple graphical decision aid for the placement of elderly people in long-term care. Journal of the Operational Research Society. 58 (4), pp. 446-453. https://doi.org/10.1057/palgrave.jors.2602179

The ICMCC second conference on "Medical and Care Compunetics"
Chaussalet, T.J. and Bos, L. 2006. The ICMCC second conference on "Medical and Care Compunetics". International Journal of Medical Informatics. 75 (9), pp. vii-viii. https://doi.org/10.1016/S1386-5056(06)00188-2

A model-based approach to the analysis of patterns of length of stay in institutional long-term care
Xie, H., Chaussalet, T.J. and Millard, P.H. 2006. A model-based approach to the analysis of patterns of length of stay in institutional long-term care. IEEE Transactions on Information Technology in Biomedicine. 10 (3), pp. 512-518. https://doi.org/10.1109/TITB.2005.863820

A method for determining an emergency readmission time window for better patient management
Demir, E., Chaussalet, T.J., Xie, H. and Millard, P.H. 2006. A method for determining an emergency readmission time window for better patient management. in: Lee, D.J., Nutter, B., Antani, S., Mitra, S. and Archibald, J. (ed.) Nineteenth IEEE International Symposium on Computer-Based Medical Systems: 22-23 June June 2006, Salt Lake City, Utah. Proceedings Las Alamitos, USA IEEE . pp. 789-793

A system for patient management based discrete-event simulation and hierarchical clustering
Codrington-Virtue, A., Chaussalet, T.J., Millard, P.H., Whittlestone, P. and Kelly, J. 2006. A system for patient management based discrete-event simulation and hierarchical clustering. in: Lee, D.J., Nutter, B., Antani, S., Mitra, S. and Archibald, J. (ed.) Nineteenth IEEE International Symposium on Computer-Based Medical Systems: 22-23 June 2006, Salt Lake City, Utah. Proceedings Las Alamitos, USA IEEE . pp. 800-804

A closed queueing network approach to the analysis of patient flow in health care systems
Chaussalet, T.J., Xie, H. and Millard, P.H. 2006. A closed queueing network approach to the analysis of patient flow in health care systems. Methods of Information in Medicine. 45 (5), pp. 492-497.

A software tool to aid long-term care budget planning at local authority level
Xie, H., Chaussalet, T.J., Toffa, S.E. and Crowther, P. 2006. A software tool to aid long-term care budget planning at local authority level. International Journal of Medical Informatics. 75 (9), pp. 664-670. https://doi.org/10.1016/j.ijmedinf.2006.04.009

Six methodological steps to build medical data warehouses for research
Szirbik, N., Pelletier, C. and Chaussalet, T.J. 2006. Six methodological steps to build medical data warehouses for research. International Journal of Medical Informatics. 75 (9), pp. 683-691. https://doi.org/10.1016/j.ijmedinf.2006.04.003

On the use of multi-state multi-census techniques for modelling the survival of elderly people in institutional long-term care
Pelletier, C., Chaussalet, T.J. and Xie, H. 2005. On the use of multi-state multi-census techniques for modelling the survival of elderly people in institutional long-term care. IMA Journal of Management Mathematics. 16 (3), pp. 255-264. https://doi.org/10.1093/imaman/dpi021

Trends in the use of hospital beds by older people in Australia: 1993-2002
Mackay, M. and Millard, P.H. 2005. Trends in the use of hospital beds by older people in Australia: 1993-2002. Medical Journal of Australia. 182 (5), pp. 252-253.

A software tool to aid budget planning for long-term care at local authority level
Xie, H., Chaussalet, T.J., Toffa, S.E. and Crowther, P. 2005. A software tool to aid budget planning for long-term care at local authority level. in: Bos, L., Laxminarayan, S. and Marsh, A.J. (ed.) Medical and care compunetics 2 Oxford, UK IOS Press.

A tool for studying the effects of residents' attributes on patterns of length of stay in long-term care
Xie, H., Chaussalet, T.J. and Millard, P.H. 2005. A tool for studying the effects of residents' attributes on patterns of length of stay in long-term care. in: Tsymbal, A. and Cunningham, P. (ed.) Proceedings of the 18th IEEE Symposium on Computer-Based Medical Systems: 23-25 June 2005, Dublin, Ireland USA IEEE . pp. 473-478

Crossing heterogeneous information sources for better analysis in long term care for elderly people
Pelletier, C., Szirbik, N. and Chaussalet, T.J. 2005. Crossing heterogeneous information sources for better analysis in long term care for elderly people. in: Bos, L., Laxminarayan, S. and Marsh, A.J. (ed.) Medical and care compunetics 2 Oxford, UK IOS Press.

Markov model-based clustering for efficient patient care
McClean, S.I., Faddy, M. and Millard, P.H. 2005. Markov model-based clustering for efficient patient care. in: Tsymbal, A. and Cunningham, P. (ed.) Proceedings of the 18th IEEE Symposium on Computer-Based Medical Systems, IEEE CBMS 2005, Dublin, Ireland, 23-24 June 2005 Los Alamitos, USA IEEE . pp. 467-472

Science not rhetoric
Mackay, M. and Millard, P.H. 2005. Science not rhetoric. Australian Nursing Journal. 12 (10), p. 3.

An interactive framework for developing simulation models of hospital accident and emergency services
Codrington-Virtue, A., Whittlestone, P., Kelly, J. and Chaussalet, T.J. 2005. An interactive framework for developing simulation models of hospital accident and emergency services. in: Bos, L., Laxminarayan, S. and Marsh, A.J. (ed.) Medical and care compunetics 2 Oxford, UK IOS Press.

A framework for predicting gross institutional long-term care cost arising from known commitments at local authority level
Pelletier, C., Chaussalet, T.J. and Xie, H. 2005. A framework for predicting gross institutional long-term care cost arising from known commitments at local authority level. Journal of the Operational Research Society. 56 (2), pp. 144-152. https://doi.org/10.1057/palgrave.jors.2601892

Addressing bed costs for the elderly: a new methodology for modelling patient outcomes and length of stay
Marshall, A.H., McClean, S.I. and Millard, P.H. 2004. Addressing bed costs for the elderly: a new methodology for modelling patient outcomes and length of stay. Health Care Management Science. 7 (1), pp. 27-33. https://doi.org/10.1023/B:HCMS.0000005395.77308.d1

Local authority fines: penny wise, pound foolish
Millard, P.H. 2004. Local authority fines: penny wise, pound foolish. British Journal of Healthcare Management. 10 (12), pp. 368-372.

Integrating data on the long-term care for elderly people from heterogeneous sources in support of research
Chaussalet, T.J. and Thompson, W.A. 2004. Integrating data on the long-term care for elderly people from heterogeneous sources in support of research. in: Proceedings of the 10th Mediterranean Conference of the International Federation for Medical and Biological Engineering (MEDICON 2004), Ischia, Italy, 31 Jul - 5 Aug 2004 Ghedimedia.

Time for a new approach for reporting herbal medicine adverse events?
Peters, D., Donaldson, J., Chaussalet, T.J., Toffa, S.E., Whitehouse, J., Carroll, D. and Barry, P. 2003. Time for a new approach for reporting herbal medicine adverse events? Journal of Alternative & Complementary Medicine. 9 (5), pp. 607-609.

Modelling survival in long term care of older people
Pelletier, C., Chaussalet, T.J. and Millard, P.H. 2003. Modelling survival in long term care of older people. 1st MEDINF International Conference on Medical Informatics and Engineering (MEDINF 2003). Craiova, Romania 06-09 Oct 2003

Mathematical modelling: how and why
Harrison, G., Ivatts, S. and Millard, P.H. 2003. Mathematical modelling: how and why. British Journal of Healthcare Management. 9 (4), pp. 144-150.

Modelling decisions of a multidisciplinary panel for admission to long-term care
Xie, H., Chaussalet, T.J., Thompson, W.A. and Millard, P.H. 2002. Modelling decisions of a multidisciplinary panel for admission to long-term care. Health Care Management Science. 5 (4), pp. 291-295. https://doi.org/10.1023/A:1020338308191

Modelling patient duration of stay to facilitate resource management of geriatric hospitals
Marshall, A.H., McClean, S.I., Shapcott, C.M. and Millard, P.H. 2002. Modelling patient duration of stay to facilitate resource management of geriatric hospitals. Health Care Management Science. 5 (4), pp. 313-319. https://doi.org/10.1023/A:1020394525938

Using a queueing model to help plan bed allocation in a department of geriatric medicine
Gorunescu, F., McClean, S.I. and Millard, P.H. 2002. Using a queueing model to help plan bed allocation in a department of geriatric medicine. Health Care Management Science. 5 (4), pp. 307-312. https://doi.org/10.1023/A:1020342509099

A queueing model for bed-occupancy management and planning of hospitals
Gorunescu, F., McClean, S.I. and Millard, P.H. 2002. A queueing model for bed-occupancy management and planning of hospitals. Journal of the Operational Research Society. 53 (1), pp. 19-24.

Modelling hospital and social care bed occupancy and use by elderly people in an English health district
Millard, P.H., Christodoulou, G., Jagger, C., Harrison, G. and McClean, S.I. 2001. Modelling hospital and social care bed occupancy and use by elderly people in an English health district. Health Care Management Science. 4 (1), pp. 57-62. https://doi.org/10.1023/A:1009605800527

Developing a Bayesian belief network for the management of geriatric hospital care
Marshall, A.H., McClean, S.I., Shapcott, C.M., Hastie, I.R. and Millard, P.H. 2001. Developing a Bayesian belief network for the management of geriatric hospital care. Health Care Management Science. 4 (1), pp. 25-30. https://doi.org/10.1023/A:1009645531478

Data requirements in a model of the natural history of Alzheimer's disease
Chaussalet, T.J. and Thompson, W.A. 2001. Data requirements in a model of the natural history of Alzheimer's disease. Health Care Management Science. 4 (1), pp. 13-19. https://doi.org/10.1023/A:1009689329661

The inappropriate placement of older people in nursing homes in England and Wales: a national audit
Victor, C., Hastie, I.R., Christodoulou, G. and Millard, P.H. 2001. The inappropriate placement of older people in nursing homes in England and Wales: a national audit. Quality in Ageing: policy, practice and research. 2 (1), pp. 16-25.

Subgroup analyses of cost of care in a Markov model of the natural history of Alzheimer's disease
Thompson, W.A. and Chaussalet, T.J. 2001. Subgroup analyses of cost of care in a Markov model of the natural history of Alzheimer's disease. in: Simulation in the Health and Medical Sciences 2001: Proceedings of the 2001 Western Multiconference, January 7-11 2001, Phoenix, Arizona California, USA Society for Computer Simulation. pp. 41-44

Editorial: Modelling the process of care
Chaussalet, T.J. and El-Darzi, E. 2001. Editorial: Modelling the process of care. Health Care Management Science. 4 (1), p. 5. https://doi.org/10.1023/A:1009659711914

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