论文标题
建模季节性病毒和医院充血的极端:瑞士医院流感的例子
Modelling the Extremes of Seasonal Viruses and Hospital Congestion: The Example of Flu in a Swiss Hospital
论文作者
论文摘要
引起流感或温和冠状病毒感冒的病毒通常被称为“季节性病毒”,因为它们在温暖的月份倾向于消退。换句话说,气象条件倾向于影响病毒的活动,并且可以利用这些信息用于医院的运营管理。在这项研究中,我们使用了瑞士最大的医院之一的三年每日数据,并专注于对表现出流感症状和流感阳性病例的患者的极端医院就诊进行建模。我们建议使用离散的广义帕累托分布来用于阳性和负面病例的数量,并为阳性病例的几率提供广义的帕累托分布。我们的建模框架允许将这些分布的参数链接到协变量效应,并通过强大的估计方法来处理外观的观测值。由于气象条件可能会随着时间的流逝而变化,因此我们使用气象和日历变化来解释医院的极端费用,而我们的经验发现突出了它们的重要性。我们提出了一项衡量医院拥堵的量度和一个相关工具,以估算不同气象条件下所得的护理(危险估计)。相关的数值计算可以使用免费的GJRM R软件包轻松进行。引入的方法可以应用于几种类型的季节性疾病数据,例如源自新病毒SARS-COV-2及其Covid-19疾病的季节性疾病数据,目前正在全球造成严重破坏。通过模拟研究评估了所提出方法的经验有效性。
Viruses causing flu or milder coronavirus colds are often referred to as "seasonal viruses" as they tend to subside in warmer months. In other words, meteorological conditions tend to impact the activity of viruses, and this information can be exploited for the operational management of hospitals. In this study, we use three years of daily data from one of the biggest hospitals in Switzerland and focus on modelling the extremes of hospital visits from patients showing flu-like symptoms and the number of positive cases of flu. We propose employing a discrete Generalized Pareto distribution for the number of positive and negative cases, and a Generalized Pareto distribution for the odds of positive cases. Our modelling framework allows for the parameters of these distributions to be linked to covariate effects, and for outlying observations to be dealt with via a robust estimation approach. Because meteorological conditions may vary over time, we use meteorological and not calendar variations to explain hospital charge extremes, and our empirical findings highlight their significance. We propose a measure of hospital congestion and a related tool to estimate the resulting CaRe (Charge-at-Risk-estimation) under different meteorological conditions. The relevant numerical computations can be easily carried out using the freely available GJRM R package. The introduced approach could be applied to several types of seasonal disease data such as those derived from the new virus SARS-CoV-2 and its COVID-19 disease which is at the moment wreaking havoc worldwide. The empirical effectiveness of the proposed method is assessed through a simulation study.