Analysis of recurrent events with non-negligible event duration, with application to assessing hospital utilization

In an attempt to provide tools for assessing hospital utilization, this paper extends well-known models for recurrent events to address non-negligible event duration and presents a procedure for estimating the model parameters. The model extension is natural and easy to understand. Asymptotic properties of the associated inferences are derived adapting the well-developed methods based on the counting process formulation. Several specifications of the proposed modeling are illustrated with the hospitalization records of childhood cancer survivors from a health care insurance system that motivated this research. The usefulness and robustness of the proposed approach is demonstrated numerically via simulation.