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posted on 2017-01-25, 12:12 authored by Julian LibreroJulian Librero, Berta Ibañez-Beroiz, Natalia Martínez-Lizaga, Salvador Peiró, Enrique Bernal-Delgado

Objective: To illustrate the ability of hierarchical Bayesian spatio-temporal models in capturing different geo-temporal structures in order to explain hospital risk variations using three different conditions: Percutaneous Coronary Intervention (PCI), Colectomy in Colorectal Cancer (CCC) and Chronic Obstructive Pulmonary Disease (COPD). Research Design: This is an observational population-based spatio-temporal study, from 2002 to 2013, with a two-level geographical structure, Autonomous Communities (AC) and Health Care Areas (HA). Setting: The Spanish National Health System, a quasi-federal structure with 17 regional governments (AC) with full responsibility in planning and financing, and 203 HA providing hospital and primary care to a defined population. Methods: A poisson-log normal mixed model in the Bayesian framework was fitted using the INLA efficient estimation procedure. Measures: The spatio-temporal hospitalization relative risks, the evolution of their variation, and the relative contribution (fraction of variation) of each of the model components (AC, HA, year and interaction AC-year).


This study is part of the Atlas of Medical Practice Variation in the Spanish National Health System research project, funded by the Instituto de Salud Carlos III (Grants PI08/90255, PI10/00494, PI14/00786, and the Spanish thematic network Red de Investiga