Beta-binomial regression and bimodal utilization.

Journal Article (Journal Article)

OBJECTIVE: To illustrate how the analysis of bimodal U-shaped distributed utilization can be modeled with beta-binomial regression, which is rarely used in health services research. DATA SOURCES/STUDY SETTING: Veterans Affairs (VA) administrative data and Medicare claims in 2001-2004 for 11,123 Medicare-eligible VA primary care users in 2000. STUDY DESIGN: We compared means and distributions of VA reliance (the proportion of all VA/Medicare primary care visits occurring in VA) predicted from beta-binomial, binomial, and ordinary least-squares (OLS) models. PRINCIPAL FINDINGS: Beta-binomial model fits the bimodal distribution of VA reliance better than binomial and OLS models due to the nondependence on normality and the greater flexibility in shape parameters. CONCLUSIONS: Increased awareness of beta-binomial regression may help analysts apply appropriate methods to outcomes with bimodal or U-shaped distributions.

Full Text

Duke Authors

Cited Authors

  • Liu, C-F; Burgess, JF; Manning, WG; Maciejewski, ML

Published Date

  • October 2013

Published In

Volume / Issue

  • 48 / 5

Start / End Page

  • 1769 - 1778

PubMed ID

  • 23521600

Pubmed Central ID

  • PMC3796113

Electronic International Standard Serial Number (EISSN)

  • 1475-6773

Digital Object Identifier (DOI)

  • 10.1111/1475-6773.12055


  • eng

Conference Location

  • United States