The authors document the development of the CMS frailty adjustment model, a Medicare payment approach that adjusts payments to a Medicare managed care organization (MCO) according to the functional impairment of its community-residing enrollees. Beginning in 2004, this approach is being applied to certain organizations, such as Program of All-Inclusive Care for the Elderly (PACE), that speciali...

Multivariate interval-censored failure time data arise commonly in many studies of epidemiology and biomedicine. Analysis of these type of data is more challenging than the right-censored data. We propose a simple multiple imputation strategy to recover the order of occurrences based on the interval-censored event times using a conditional predictive distribution function derived from a paramet...

Department of Statistics, University of Pune, Pune-411007, India. Email: david−[email protected]; richa−[email protected] Abstract In this paper, we consider two different shared frailty regression models under the assumption of Gompertz as baseline distribution. Mostly assumption of gamma distribution is considered for frailty distribution. To compare the results with gamma frailty model, ...

In studies of complex health conditions, mixtures of discrete outcomes (event time, count, binary, ordered categorical) are commonly collected. For example, studies of skin tumorigenesis record latency time prior to the first tumor, increases in the number of tumors at each week, and the occurrence of internal tumors at the time of death. Motivated by this application, we propose a general unde...

BACKGROUND Frailty is a state of increased vulnerability to poor resolution of homeostasis after a stressor event, which increases the risk of adverse outcomes including falls, disability and death. The underlying pathophysiological pathways of frailty are not known but the hypothalamic-pituitary-adrenal axis and heightened chronic systemic inflammation appear to be major contributors. METHOD...

OBJECTIVES To determine the degree to which hyperglycemia predicts the development of frailty and lower extremity mobility limitations. DESIGN Secondary data analysis of longitudinal data collected in a prospective cohort study. SETTING Baltimore, Maryland. PARTICIPANTS Three hundred twenty-nine women from the Women's Health and Aging Study II aged 70 to 79 at baseline who had all variabl...

BACKGROUND Frailty describes the aging-associated loss of physiological and psychological reserves, leading to an increased risk of adverse health outcomes. Many developed countries view frailty as a major priority for their health and social care systems. Less is known about frailty in less-developed countries. The purpose of this study was to determine the prevalence of frailty in a sample of...

Data from 350 herds enrolled in the Norwegian Dairy Herd Recording System (NDHRS) were used to investigate the associations between the first two cow-milk somatic cell counts (SCC) test-days' results after calving or the three last SCC test-days prior to drying off in the first lactation and the hazard ratio (HR) of clinical mastitis (CM) during the remaining first or the subsequent second lact...

The RECIST criteria are used as standard guidelines for the clinical evaluation of cancer treatments. The assessment is based on the anatomical tumor burden: change in size of target lesions and evolution of non-target lesions, ie. appearance of new lesions and progression of non-target lesions. Despite indisputable advantages of this standard tool, RECIST are subject to some limitations such a...