Analysis of Interrupted Time Series Mortality Trends: An Example to Evaluate Regionalized Perinatal Care.

Interrupted time series designs are frequently employed to evaluate program impact. Analysis strategies to determine if shifts have occurred are not well known. The case where statistical fluctuations (errors) may be assumed independent is considered, and a segmented regression methodology presented...

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Publicado en:American Journal of Public Health Vol. 71; no. 1; pp. 38 - 47
Autores principales: Gillings, Dennis, Makuc, Diane, Siegel, Earl
Formato: Artículo
Publicado: American Public Health Association Jan1981
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Analysis of Interrupted Time Series Mortality Trends: An Example to Evaluate Regionalized Perinatal Care.
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          Gillings, Dennis
          Makuc, Diane
          Siegel, Earl
        affil:
          Associate Professor, Department of Biostatistics, School of Public Health 201H, University of North Carolina, Chapel Hill, NC 27514.
          Statistician, Office of Deputy Assistant Secretary for Planning and Evaluation/Health, Dept. of HHS, Washington, DC.
          Professor, Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill.
      su:
        Mortality
        Perinatal death
        Maternal health services
        Perinatal care
        Neonatal mortality
        Prenatal care
        Postnatal care
        Racial differences
        North Carolina
      sug:
        subj:
          North Carolina
          Mortality
          Perinatal death
          Maternal health services
          Perinatal care
          Neonatal mortality
          Prenatal care
          Postnatal care
          Racial differences
      ab: Interrupted time series designs are frequently employed to evaluate program impact. Analysis strategies to determine if shifts have occurred are not well known. The case where statistical fluctuations (errors) may be assumed independent is considered, and a segmented regression methodology presented. The method discussed is applied to the assessment of changes in local and state perinatal postneonatal mortality to identify historical trends and will be used to evaluate the impact of the North Carolina Regionalized Perinatal Care Program when seven years of postprogram mortality data become available. The perinatal program region is contrasted with a control region to provide a basis for interpretation of differences noted. Relevant segmented regression models provided good fits to the data and highlighted mortality trends over the last 30 years. Considerable racial differences in these trends were identified, particularly for postneonatal mortality. Segmented regression is considered relevant for the analysis of interrupted time series designs in other applications when errors can be taken to be independent. Thus, the methodology may be regarded as a general statistical tool for evaluation purposes.
      pubtype: Academic Journal
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    language: English
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