An Ordinal Latent Markov model for the evaluation of Health Care services

This work studies the dynamic behavior of the health status of some elderly hosted in different nursing homes. Specifically, we consider a dataset gathered from the Long Term Care Facilities (LTCF) Programme, a longitudinal study carried on in Umbria (Italy). The final goal of our analysis is to understand whether the evolution of elderly’ health conditions significantly change across different nursing homes. To this end, an ordinal Latent Markov model accounting for both dropout and intermittent missing data patterns is proposed. Then, some performance measures are computed on a standardized elderly population in order to rule out the effect of patient case-mix.