Estimating effects of time-varying exposures on mortality risk.

ABSTRACT: Administrative databases have become an increasingly popular data source for population-based health research. We explore how mortality risk is associated with some health service utilization process via linked administrative data. A generalized Cox regression model is proposed using a time-dependent stratification variable to summarize lifetime service utilization. Recognizing the service utilization over time as an internal covariate in the survival analysis, conventional likelihood methods are inapplicable. We present an estimating function based procedure for estimating model parameters, and provide a testing procedure for updating the stratification levels. The proposed approach is examined both asymptotically and numerically via simulation. We motivate and illustrate the proposed app

SUBMITTER: Thomson TJ 

PROVIDER: S-EPMC11404390 | biostudies-literature | 2024

REPOSITORIES: biostudies-literature