Bayesian Extensions of the Tobit Model for Analyzing Measures of Health Status

Self-reported health status is often measured using utility indices that provide a score intended to summarize an individual’s health. Measurements of health status can be subject to a ceiling effect. Frequently, researchers want to examine relationships between determinants of health and measures of health status. In this article, Bayesian extensions of the classical Tobit model are used to study the relationship between health status and predictors of health. The author examined models where the conditional distribution of health status was either normal or lognormal, and allowed for both homoscedasticity and heteroscedasticity. Bayes factors were then used to compare the evidence for a given model against that for a competing model. The author found very strong evidence that the distribution of the Health Utilities Index, conditional on age, gender, income adequacy, and number of chronic conditions, was normal with nonuniform variance, compared to the competing models.

[1]  A. Stewart,et al.  Methods of Constructing Health Measures , 1992 .

[2]  Li Kai,et al.  Bayesian inference in a simultaneous equation model with limited dependent variables , 1998 .

[3]  M. Escobar,et al.  The use of the Tobit model for analyzing measures of health status , 2004, Quality of Life Research.

[4]  K J Rothman,et al.  That confounded P-value. , 1998, Epidemiology.

[5]  R L Kane,et al.  Methodology for measuring health-state preferences--I: Measurement strategies. , 1989, Journal of clinical epidemiology.

[6]  A. Stewart,et al.  Measuring Functioning and Well-Being: The Medical Outcomes Study Approach , 1992 .

[7]  G. Maddala.  Limited-dependent and qualitative variables in econometrics: Introduction , 1983 .

[8]  John Geweke,et al.  Evaluating the accuracy of sampling-based approaches to the calculation of posterior moments , 1991 .

[9]  S. Chib.  Bayes inference in the Tobit censored regression model , 1992 .

[10]  J. Tobin.  Estimation of Relationships for Limited Dependent Variables , 1958 .

[11]  Steven X. Wei,et al.  A bayesian approach to dynamic tobit models , 1999 .

[12]  D. Feeny,et al.  Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. , 1996, Medical care.

[13]  D. Feeny,et al.  Health Utilities Index Mark 3 , 2016 .

[14]  P. Schmidt,et al.  Limited-Dependent and Qualitative Variables in Econometrics. , 1984 .

[15]  HMO selection and Medicare costs: Bayesian MCMC estimation of a robust panel data tobit model with survival. , 1999, Health economics.

[16]  Peter C Austin,et al.  A comparison of methods for analyzing health-related quality-of-life measures. , 2002, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[17]  B. Carlin,et al.  Bayesian Tobit Modeling of Longitudinal Ordinal Clinical Trial Compliance Data with Nonignorable Missingness , 1996 .

[18]  T. To,et al.  Measuring Population Health: Correlates of the Health Utilities Index Among English and French Canadians , 2000, Canadian journal of public health = Revue canadienne de sante publique.