Resources allocation in healthcare for cancer: a case study using generalised additive mixed models

Musio, Monica and Sauleau, Erik A. and Augustin, Nicole H. (2012) Resources allocation in healthcare for cancer: a case study using generalised additive mixed models. Geospatial Health, 7 (1). pp. 83-89. ISSN 1970-7096

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Abstract

Our aim is to develop a method for helping resources re-allocation in healthcare linked to cancer, in order to replan the allocation of providers. Ageing of the population has a considerable impact on the use of health resources because aged people require more specialised medical care due notably to cancer. We propose a method useful to monitor changes of cancer incidence in space and time taking into account two age categories, according to healthcar general organisation. We use generalised additive mixed models with a Poisson response, according to the methodology presented in Wood, Generalised additive models: an introduction with R. Chapman and Hall/CRC, 2006. Besides one-dimensional smooth functions accounting for non-linear effects of covariates, the space-time interaction can be modelled using scale invariant smoothers. Incidence data collected by a general cancer registry between 1992 and 2007 in a specific area of France is studied. Our best model exhibits a strong increase of the incidence of cancer along time and an obvious spatial pattern for people more than 70 years with a higher incidence in the central band of the region. This is a strong argument for re-allocating resources for old people cancer care in this sub-region

Item Type:	Article
Uncontrolled Keywords:	Health policy, generalised additive mixed models, resources allocation, cancer incidence, space-time models
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 614 Medicina legale; incidenza delle malattie; Medicina preventiva pubblica
Depositing User:	Chiara D'Arpa
Date Deposited:	31 Jul 2014 10:55
Last Modified:	31 Jul 2014 10:55
URI:	http://eprints.bice.rm.cnr.it/id/eprint/9149

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