Healthcare center clustering for Cox's proportional hazards model by fusion penalty

Stat Med. 2023 Sep 10;42(20):3685-3698. doi: 10.1002/sim.9825. Epub 2023 Jun 14.

Abstract

There has been growing research interest in developing methodology to evaluate healthcare centers' performance with respect to patient outcomes. Conventional assessments can be conducted using fixed or random effects models, as seen in provider profiling. We propose a new method, using fusion penalty to cluster healthcare centers with respect to a survival outcome. Without any prior knowledge of the grouping information, the new method provides a desirable data-driven approach for automatically clustering healthcare centers into distinct groups based on their performance. An efficient alternating direction method of multipliers algorithm is developed to implement the proposed method. The validity of our approach is demonstrated through simulation studies, and its practical application is illustrated by analyzing data from the national kidney transplant registry.

Keywords: fixed effects; fusion penalty; latent class; provider profiling; random effects.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Algorithms*
  • Cluster Analysis
  • Computer Simulation
  • Delivery of Health Care*
  • Humans
  • Proportional Hazards Models