RESUMO
Length of hospital stay (LOS) is an important indicator of the hospital activity and management of health care. The skewness exhibited by this variable poses problems in statistical modeling. The aim of this work is to model the variable LOS within diagnosis-related groups (DRG) through finite mixtures of distributions. A mixture of the union of Gamma, Weibull and Lognormal families is used in the model, instead of a mixture of a unique distribution family. Some theoretical questions regarding the model, such as the identifiability and study of asymptotic properties of ML estimators, are analyzed. The EM algorithm is proposed for performing these estimators. Finally, this new proposed model is illustrated by using data from different DRGs.
Assuntos
Tempo de Internação/estatística & dados numéricos , Algoritmos , Biometria , Grupos Diagnósticos Relacionados/estatística & dados numéricos , Humanos , Funções Verossimilhança , Modelos EstatísticosRESUMO
A case of breast carcinoma presenting as cutaneous metastases on sites other than the anterior chest wall is reported. Multiple nodules, in numbers (reaching 900) not previously reported, were widely distributed, even to the thighs and pelvic region, which are areas not previously reported as sites of cutaneous metastases from breast carcinoma. This patient's case is further characterized by an adenocarcinoma pattern in the presenting skin lesions and a thirty-five months' survival time from the appearance of the cutaneous metastases. We emphasize the need to remove excisional biopsy specimens of unexplained skin nodules. Breast carcinoma is the most common internal malignant primary tumor in women.
