Giorgio Eduardo Montanari

University of Perugia | UNIPG · Political sciences

Evaluating the performance of health care institutions is of paramount interest and it is often conducted using generalized linear mixed models. In this paper, we focus on the evaluation of Nursing Homes for elderly residents in a region of Italy and concentrate on binary outcomes (death and worsening). We propose to use a routinely assessed covari...

In this paper, we propose a general class of indices that can be used for comparing the performances of organizations providing a given public service to citizens, such as universities, hospitals, nursing homes, employment agencies or other institutions. In particular, we handle the case where evaluation is performed by assessing the probability th...

In Italy, academic departments are ranked according to a function of the scores assigned by ANVUR (an appointed national agency) to some of their scientific products. We show how intra-department correlation among these scores affects the overall validity of currently-in-use procedures. For this correlation, we also outline an identification and es...

Two indices for the evaluation of the performance of the nursing homes are introduced. These indices properly take into account the case-mix, that is, the different complexity each nursing home copes with at baseline. Two estimators are consequently derived, whose finite-sample behavior is studied in simulation.

In this paper, an ordinal multilevel latent Markov model based on separate random effects is proposed. In detail, two distinct second-level discrete effects are considered in the model, one affecting the initial probability vector and the other affecting the transition probability matrix of the first-level ordinal latent Markov process. To model th...

Over the years, the Order of Social workers of Umbria put particular effort into the un-derstanding of the educational needs of its members. Currently, it is performing some initiatives that were based on the study carried out ten years ago, which involved 255 social workers in the region (45% of the members), 67% of whom working in the public real...

Rivista Piccola Impresa/Small Business, n. 3, anno 2020 Codice ISSN 0394-7947 - ISSNe 2421-5724 __________________________________________________________________________________________________________________________________________ The article aims to analyze and evaluate public financial resources for applied scientific research and innovation...

We compare two regression-based estimators of treatment/policy effects in a standard difference-in-differences setting without additional covariates. These two estimators, deriving from what we term the piled and unpiled regression models, produce identical finite-sample estimates, thus sharing the same theoretical variance. However, they are not e...

In this paper, we aim at ranking a set of nursing homes based on their ability in maintaining their residents’ physical conditions as good as possible. In this respect, we propose a nursing home performance indicator, which is essentially a probability to avoid resident health status worsening. Specifically, latent Markov models with covariates and...

Il Capitolo 7 riporta i risultati degli studi controfattuali realizzati confrontando due campioni, uno costituito da imprese che hanno beneficiato dei progetti agevolati con fondi pubblici e l’altro costituito da imprese non beneficiarie avente la funzione di campione di controllo. Il Capitolo si conclude con alcune considerazioni sui risultati rag...

Il volume è frutto di un accordo di collaborazione sottoscritto tra l’Assemblea legislativa della Regione Umbria - Servizio Studi, Valutazione delle politiche e Organizzazione e l’Università degli Studi di Perugia - Dipartimento di Scienze politiche, per la realizzazione di attività a supporto della funzione di valutazione delle politiche pubbliche...

Infine, nelle Conclusioni si riassume in breve il percorso fatto e si formulano indicazioni utili per una possibile prosecuzione del lavoro, essendo la valutazione delle politiche un campo assai complesso, in cui la ricostruzione di cosa sarebbe successo senza di esse per valutarne l’effetto netto non può che procedere per approssimazioni successiv...

Il Capitolo 5 presenta uno studio sulle imprese beneficiarie di contributi nell'ambito dei Piani Operativi Regionali finanziati dai fondi FESR per il settennio 2007-2013 e il settennio 2014-2020. I dati riportati consentono di apprezzare il volume delle attività svolte, l'ammontare dei contributi concessi, il numero delle imprese che ne hanno benef...

We consider the Difference in Difference method for estimating policy impacts in an observational study framework where effects are multiplicative and sample units are different in size. In this case, the natural counterpart is the Ratio of Ratios method, but there are other alternatives that we discuss to some extent.

In this paper, a multilevel latent Markov model is proposed where through discrete random effects a two-way classification of sample unit clusters is obtained. Such random effects are defined as two discrete random variables, one of which affecting the initial probabilities and the other one affecting the transition probabilities of the Markovian l...

Estimation of small area totals makes use of auxiliary variables to borrow strength from related areas through a model. Precision of final small area estimates depends on the validity of such a model. To protect against possible model failures, benchmarking procedures make the sum of small area estimates match a design consistent estimate of the to...

The periodic evaluation of health care services is a primary concern for many institutions. We consider services provided by nursing homes with the aim of ranking a set of these structures with respect to their effect on resident health status. Since the overall health status is not directly observable, and given the longitudinal and multilevel str...

In the social, behavioral, and health sciences it is often of interest to identify latent or unobserved groups in the population with the group membership of the individuals depending on a set of observed variables. In particular, we focus on the field of nursing home assessment in which the response variables typically come from the administration...

SOMMARIO - Definizioni e misure - Aspettativa di vita e disabilità in Umbria - Speranza di vita e differenze di genere - Altri indicatori della salute in Umbria: la speranza di vita senza malattie croniche e in buona salute a 65 anni - Considerazioni conclusive

In this work, a multilevel Latent Markov model is proposed to study the evolution of the health status of elderly patients hosted in different nursing homes. A dataset is considered which is gathered from the Long Term Care Facilities programme , a longitudinal study carried on in Umbria (Italy). The data at hand cover the years 2012 and 2013. The...

The periodic evaluation of health care services is a primary concern for many institutions. In this work, we focus on nursing home services with the aim to produce a ranking of a set of nursing homes based on their capability to improve-or at least to keep unchanged-the health status of the patients they host. As the overall health status is not di...

We focus on the evaluation of the long-term health care services provided to elderly patients by nursing homes of four different health districts in the Umbria region (Italy). To this end, we analyze data coming from a longitudinal survey aimed at assessing several aspects of patient health conditions and develop an extended version of the latent M...

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 c...

In environmental studies, it is a common practice to follow the continuous-plane paradigm for estimating parameters of interest, like totals or means, of a spatial variable defined over a surface whose points correspond to points of a connected and compact subset of . In the design-based approach, randomness comes from the random sampling of points...

In this work, we focus on the evaluation of the health care services provided to elderly patients by nursing homes of four different health districts in the Umbria region (Italy). For this purpose, we analyze data coming from a longitudinal survey aimed at assessing several aspects of patient health conditions. In the analysis , we employ an extend...

The evaluation of nursing homes is usually based on the administration of questionnaires made of a large number of polytomous items to their patients. In such a context, the latent class model represents a useful tool for clustering subjects in homogenous groups corresponding to different degrees of impairment of the health conditions. It is known...

In environemtale studies, it is a common practice to follow the continuous-plane paradigm to estimate parameters of interest referring to a spatial variable, defined over a surface whose points correspond to points of a compact subset of finite extension of R2. In the design-based approch to inference, randomness comes from the random sampling of p...

This article considers the estimation of the number of severely disabled people using data from the Italian survey on Health Conditions and Appeal to Medicare. In this survey, disability is indirectly measured using a set of categorical items, which consider a set of functions concerning the ability of a person to accomplish everyday tasks. Latent...

We propose a modified version of the three-step estimation method for the latent class model with covariates, which may be used to estimate latent Markov models for longitudinal data. The three-step estimation approach we propose is based on a preliminary clustering of sample units on the basis of the time specific responses only. This approach rep...

We compare different estimation methods for latent Markov models with covariates. These models represent a powerful tool for the analysis of longitudinal categorical data when the interest is to represent the evolution of a latent characteristic of a sample of units over time. In applications to complex data, with a large number of observed respons...

The evaluation of nursing homes is usually based on the administration of questionnaires made of a large number of polytomous items. In such a context, the Latent Class (LC) model represents a useful tool for clustering subjects in homogenous groups corresponding to different degrees of impairment of the health conditions. It is known that the perf...

In a previous paper, the authors addressed the problem of the estimation of the mean of a spatial population in a design-based context and proposed a modelassisted estimator based on penalized regression splines. This paper goes a step further exploring the performance of the leave-one-out cross-validation criterion for selecting the amount of smoo...

Uno dei presupposti ideali per lo svolgimento di un’indagine campionaria è quello di poter osservare le modalità delle variabili oggetto d’indagine in tutte le unità selezionate per fare parte del campione. In realtà questa condizione difficilmente risulta soddisfatta e si verifica molto spesso che una parte delle unit`a campionarie non collaborino...

Nel corso del processo in cui si progetta e realizza un’indagine le possibilità di errore non campionario sono molte. Gli errori di copertura sono i primi in cui si può incorrere. Essi, definiti nel Par. 1.2.4, nascono dalla non corrispondenza tra le popolazioni obiettivo e frame e possono essere attribuiti a chi realizza l’indagine, perché non ha...

Nel capitolo precedente sono stati richiamati in modo schematico i principali piani di campionamento di uso corrente evidenziando il ruolo fondamentale delle informazioni disponibili nel frame. Ad esempio, conoscere la dislocazione territoriale delle unità statistiche consente di predisporre una stratificazione territoriale; oppure, nel caso sia no...

Lo scopo introduttivo di questo capitolo è quello di richiamare i concetti fondamentali del campionamento da popolazioni finite. Dopo alcune definizioni preliminari e una breve disquisizione sulla terminologia in uso, vengono ricordate le fasi di una indagine statistica e individuati gli errori che in ciascuna di esse possono aver origine. Come si...

Il presente capitolo riguarda i campioni probabilistici secondo la definizione fornita nel Par. 2.3 e fa riferimento a una situazione del tutto ideale. Così, si suppone che le unità delia popolazione frame, di numerosità nota e pari a N, coincidano con quelle della popolazione target e che tutte le unità comprese nel campione forniscano le risposte...

With reference to a questionnaire aimed at assessing the performance of Italian nursing homes on the basis of the health conditions of their patients, we investigate two relevant issues: dimensionality of the latent structure and discriminating power of the items composing the questionnaire. The approach is based on a multidimensional item response...

In the last decade, calibration has been used to reduce both sampling error and nonresponse bias in surveys. In the presence of auxiliary variables with known population totals or with known values on the originally sampled units, the calibration procedure generates final weights for observations that, when applied to those auxiliary variables, yie...

This article considers the estimation of the number of severely disabled people using data from the Italian survey on Health Conditions and Appeal to Medicare. Disability is indirectly measured using a set of categorical items, which survey a set of functions concerning the ability of a person to accomplish everyday tasks. Latent Class Models can b...

Cet article traite de l'estimation de la moyenne d'une population spatiale. Dans le cadre d'une approche fondée sur un plan d'échantillonnage, un estimateur assisté par un modle de régression spline pénalisé est proposé et étudié. Nous montrons que cet estimateur est convergent (dans le cadre du plan) et établissons sa loi normale asymptotique. Une...

The evaluation of nursing homes and the assessment of the quality of the health care provided to their patients are usually based on the administration of questionnaires made of a large number of polytomous items. In applications involving data collected by questionnaires of this type, the Latent Class (LC) model represents a useful tool for classi...

This paper aims at classifying, on the basis of their disability profile, the population of elderly and quantifying the number of those with a very low level of functioning in a central region of Italy. This is accomplished using a set of variables on the difficulty of accomplishing everyday tasks (Activities of Daily Living, ADL) and functions. Th...

With reference to the questionnaire adopted within the Italian project "Ulisse" to assess health condition of elderly people, we investigate two important issues: discriminant power and actual number of dimensions measured by the items composing the questionnaire. The adopted statistical approach is based on the joint use of the latent class model...

The Region Umbria has conducted a survey on elderly patients living in long-term care facilities since the year 2000. Repeated measurements of items on health conditions are taken for classifying care facilities to allocate resources (RUG system). We wish to evaluate the performance of the nursing homes in terms of some aspects of health condition...

Performance evaluation of nursing homes is usually accomplished by the repeated administration of questionnaires aimed at measuring the health status of the patients during their period of residence in the nursing home. We illustrate how a latent Markov model with covariates may effectively be used for the analysis of data collected in this way. Th...

Model calibration (Wu & Sitter, JASA, 2001) has been shown to provide more efficient estimates than classical calibration when the values of one or more auxiliary variables are available for each unit in the population and the relationship between such variables and the variable of interest is more complex than a linear one. Model calibration, thou...

Estimation of small area totals makes use of auxiliary variables to borrow strength from related areas through a model. Precision of final small area estimates depends on the validity of such a model. To protect against possible model failures, benchmarking procedures make the sum of small area estimates match a design consistent estimate of the to...

We propose a class of estimators of the variance of the systematic sample mean, which is unbiased under the assumption that the population follows a superpopulation model that satisfies some mild conditions. The approach is based on the separate estimation of the portion of the variance due to the systematic component of the model and that due to t...

The Generalized regression estimator (GREG) of a finite population mean or total has been shown to be asymptotically optimal when the working linear regression model upon which it is based includes variables related to the sampling design. In this paper a regression estimator assisted by a linear mixed superpopulation model is proposed. It accounts...

Calibration is commonly used in survey sampling to include auxiliary information at the estimation stage of a population parameter. Calibrating the observation weights on the population means (or totals) of a set of auxiliary variables means building weights that when applied to the auxiliaries give exactly their population mean (total). Implicitly...

Nonparametric techniques have only recently been employed in the estimation procedure of finite population parameters in a model-assisted framework. When complete auxiliary information is available, the use of more flexible methods to predict the value taken by the survey variable in non sampled units allows building more efficient estimators. Here...

Il lavoro presenta una rassegna della letteratura sull’impiego di tecniche di regressione nonparametrica nell’inferenza assistita dal modello su popolazioni finite di carattere ambientale. Affronta poi il problema della stima della funzione di distribuzione di una variabile oggetto di indagine in presenza di informazione ausiliaria completa. I...

Since the attempt to evidence structural brain damage in Parkinson's disease (PD) by conventional magnetic resonance imaging (MRI) is usually disappointing, we have investigated whether the magnetization transfer ratio (MTR) can reflect changes in grey and white matter of PD patients. MTR was quantified in 44 regions of interest (ROIs) in both grey...

This paper reviews conditional properties of the mean and total estimators of a finite population when auxiliary information is available. An exact design-based conditional analysis for complex sampling designs is intractable, but an asymptotic conditional framework can be developed. Within such a framework the paper establishes sufficient conditio...

In this paper we introduce an enlarged class of generalised re- gression estimators of a finite population mean that includes as special case the optimal estimator. Theoretical results show that the latter can be seen as a generalised regression estimator based on a suitable superpopulation lin- ear regression model. Then, an estimation procedure a...

We review the conditional properties of finite population mean and total estimators when auxiliary information is available. The conditional approach has been only recently brought to the attention of researchers, especially because of work on the predictive approach to finite population inference. An exact design-based conditional analysis for com...

We propose a new estimator of the variance of the systematic sample mean, which is based on a sum of two components: the first takes into account ofthe trend in the population list, the second takes into account of the stochastic component of a general superpopulation model. Such an estimator is compared with the simple random sampling variance est...

This paper examines the main properties of the generalized regression estimator of a finite population mean and those of the regression estimator obtained from the optimal difference estimator. Given that the latter can be more efficient than the former, conditions allowing this to happen are established, and a criterion for choosing between the tw...

We examined the problem of estimating the mean of a spatial phenomenon (geological or soil characteristic, depth of rainfall, fertility, pollutant concentration, etc.) and we compared the two currently used inference approaches, namely the randomization approach and the predictive approach, taking into account the presence of spatial autocorrelatio...

Il presente lavoro riporta alcuni iniziali risultati di una sperimentazione condotta al fine di acquisire elementi conoscitivi sugli effetti della variabilità campionaria delle stime dei dati di mvimento aggregati sulle successive analisi demografiche ed in particolare sulla tecnica di ricostruzione di popolazioni storiche conosciuta con il nome di...

Per giungere alla stima di serie storiche aggregate relative a territori di ragguardevoli dimensioni appare scelta obbligata lavorare su serie storiche parziali relative ad un campione limitato di entità territoriali. In questo lavoro si individano alcuni stimatori ottimali a partire da un modello predittivo nell'ambito dell'inferenza su popolazion...

Wright (1983) introduced the class of QR-predictors to estimate a finite population mean under a regression superpopulation model. In the present paper we enlarge that class to include more general predictors and generalize some results in order to obtain asymptotic design-unbiasedness. Then, using first-order approximations, optimal predictors are...

Sometimes, it is sufficient a change of origin of a quantitative survey variable to reduce the variance of the Horvtiz-Thompson estimator of the total in unequal probability sampling. Stuart (1986) calls this operation "location-shifts". In the present paper this technique is studied, in a more general framework, with regard to an assumed superpopu...

This study speaks about the relationship between olive fly (D. oleae) ovipositing and certain physical parameters of drupes. During the first period of observation weight was the most important parameter statistically. Subsequently, this relationship became less important because of the remarcable increase in the density of population and because o...

In questo lavoro vengono presentati i risultati di un'indagine condotta nel 1980 nell'ambiente olivicolo della Toscana litoranea sull'influenza dei fattori cultivar, produzione, esposizione e livello di chioma nel confronti dell'attacco dacico e sulla relazione tra l'infestazione del frutto pendente e quello della cascola.

In this paper we study the effect of temperature and of amount of rainfall on the death rate of first-stage larvae of Saissetia Oleae (Oliv.) and the spatial distribution of the insects between leaves and branchlets.

Indirect estimators for small areas use auxiliary variables to borrow strength from related areas through a linking model. Precision of indirect estima-tors depends on the validity of such a model. To protect against possible model failures, benchmarking procedures make the total of small area estimates match a design consistent estimate for a larg...

Riassunto: Il lavoro presenta una rassegna della letteratura sull'impiego di tecniche di regressione nonparametrica nell'inferenza assistita dal modello su popolazioni finite di carattere ambientale. Affronta poi il problema della stima della funzione di distribuzione di una variabile oggetto di indagine in presenza di informazione ausiliaria compl...

Model calibration has been shown to provide more efficient estimates than classical calibration when the values of one or more auxiliary variables are available for each unit in the population and the relationship between such variables and the variable of interest is more complex than a linear one. Model calibration, though, provides a different s...