Prior distributions expressing ignorance about convex increasing failure rates

This paper deals with the specification of probability distributions expressing ignorance concerning annual or otherwise discretized failure or mortality rates, when these rates can safely be assumed to be increasing and convex, but are completely unknown otherwise. Such distributions can be used as noninformative priors for Bayesian analysis of failure data. We demonstrate why a uniform distribution used in earlier work is unsatisfactory, especially from the point of view of insensitivity with respect to the time scale that is chosen for the problem at hand. We suggest alternative distributions based on Dirichlet distributed weights for the extreme points of relevant convex sets, and discuss which consequences a requirement for scale neutrality has for the choice of Dirichlet parameters.     

Bayesian Inference for Hospital Quality in a Selection Model

This paper develops new econometric methods to infer hospital quality in a model with discrete dependent variables and nonrandom selection. Mortality rates in patient discharge records are widely used to infer hospital quality. However, hospital admission is not random and some hospitals may attract patients with greater unobserved severity of illness than others. In this situation the assumption of random admission leads to spurious inference about hospital quality. This study controls for hospital selection using a model in which distance between the patient's residence and alternative hospitals are key exogenous variables. Bayesian inference in this model is feasible using a Markov chain Monte Carlo posterior simulator, and attaches posterior probabilities to quality comparisons between individual hospitals and groups of hospitals. The study uses data on 74,848 Medicare patients admitted to 114 hospitals in Los Angeles County from 1989 through 1992 with a diagnosis of pneumonia. It finds the smallest and largest hospitals to be of the highest quality. There is strong evidence of dependence between the unobserved severity of illness and the assignment of patients to hospitals, whereby patients with a high unobserved severity of illness are disproportionately admitted to high quality hospitals. Consequently a conventional probit model leads to inferences about quality that are markedly different from those in this study's selection model.