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var(β 1 ) For ”Reference Level” Coding

D. var(β 1 ) Under AN Unbalanced Design

2. var(β 1 ) For ”Reference Level” Coding

No matter how the independent variables are coded, the multilevel generalized linear model’s linearization is the same as (D.13). In this section, I will derive the variance of race which is coded as 1 for black and 0 for white veterans.The same unbalance design scenarios as discussed in Appendix D.D.2will be considered, here.

a. In RI Model

Adapting the general linearized 2-level logistic model (D.13) to the 2 level RI model, adjusted by one binary variable and coded as 1 in black and 0 for white race, yields the following results:

yij = β0+ xijβ1+ µ0j+ εij (D.102)

To identify the black effect, I can rewrite the model (D.14) as the race specific models

yijA = β0+ β1+ µ0j+ εij for black

yijW = β0+ µ0j+ εij for white (D.103)

Therefore, the average linearized race specific response at jth site are shown as (D.104) and (D.105) for black and white, respectively.

¯ y.jB =

PnjB

i=10+ β1+ µ0j+ εijB) njB

for black

=

PnjB

i=10) +PnjB

i=11) +PnjB

i=10j) +PnjB i=1ijB) njB

= njBβ0+ njBβ1+ njBµ0j +PnjB i=1ijB) njB

= β0+ β1+ µ0j+ ¯ε.jB (Eε.jB = 0)

= β0+ β1+ µ0j

(D.104)

¯

Similarly, we can get an average outcome as shown below.

¯

Therefore, the GLS estimate of race can be obtained by

¯

y..B − ¯y..W = β0+ β1− β0 = β1 (D.108)

By applying the corresponding f(H) to (D.12) and (D.11), the modified yij and εij results in yij = (yij− ˜πij)[˜πij(1 − ˜πij)]−1+ β0+ xijβ1

εij = εij[˜πij(1 − ˜πij)]−1 (D.109)

Then, applying Vjµ20 to var(Yij) as (D.17) for RI model yields

var(Yij) = σµ20 + [˜πij(1 − ˜πij)]−1 (D.110) Based on the linearized 2-level logistic model (D.13) and by applying the GLS estimate of β1 as (D.108), I get

I have presented yijB and yijW as (D.103). Plugging in (D.111), I will get

βˆ1 =

β0 and β1 will be constant everywhere.

βˆ1 = β0+ β1+ µ0+

As known, var(εijB) or var(εijW) are the same as σε2∗ijB and σε2∗ijW in different cells. I can write the above equation as

var( ˆβ1) = (PN

2: The related sample size from (D.21) shows as n1 = n2 = · · · = nj = n, and PN

For condition Bw¯: The related sample size from (D.21) shows as

XN

I can write (D.113) as

var( ˆβ1) = σε2∗ijB

For condition Bwj: The related sample size from (D.20) shows as

I can write (D.114) as

var( ˆβ1) = σ2∗εijB

2: The related sample size from (D.20) shows as n1 = n2 = · · · = nj = n, and PN

The related sample size from (D.20) shows as

XN

Equation (D.113) can be written as

The related sample size from (D.20) shows as

XN

b. In RC Model

Adapting the general linearized 2-level logistic model (D.13) to the 2 level RC model, yields the following rsults: adjusted by race, and coded as 1 for black and 0 fir white race.

yij = β0+ xijβ1 + µ0j+ µ1j+ εij (D.124)

To identify the fixed effect of black race, I can rewrite the model (D.14) as the race specific models

yijA = β0+ β1 + µ0j+ µ1j+ εij for black

yijW = β0+ µ0j+ εij for white (D.125)

Therefore, the average linearized race specific responses at jth site are shown as (D.126) and (D.127) for black and white, respectively.

¯

Similarly, the average outcome yields

Therefore, the GLS estimate of race can be obtained by

¯

y..B − ¯y..W = β0+ β1− β0 = β1 (D.130) By applying corresponding f(H) to (D.12) and (D.11), the modified yij and εij result in

yij = (yij− ˜πij)[˜πij(1 − ˜πij)]−1+ β0+ xijβ1

εij = εij[˜πij(1 − ˜πij)]−1 (D.131)

Then, applying Vjµ20 to var(Yij) as (D.17) for the RI model yields

var(Yij) = σµ20 + σ2µ1 + [˜πij(1 − ˜πij)]−1 (D.132)

Based on the linearized 2-level logistic model (D.13) and by applying the GLS estimate of

I have presented yijB and yijW as (D.125). Plugging in (D.133), I will get

βˆ1 =

β0 and β1 will be constant everywhere. µ0j will be constant at jth hospital.

βˆ1 = β0+ β1+

For condition B1

2: The related sample size from (D.21) shows as n1 = n2 = · · · = nj = n, and PN

For condition Bw¯: The related sample size from (D.20) shows as

XN

I can write (D.136) as

var( ˆβ1) = σµ21

For condition Bwj: The related sample size from (D.20) shows as

XN

I can write (D.136) as

2: The related sample size from (D.20) shows as n1 = n2 = · · · = nj = n, and PN

The related sample size from (D.20) shows as

XN

Equation (D.136) can be written as

The related sample size from (D.20) shows as

XN

APPENDIX E

IMAGE OF MLWIN RESULTS USING MLWIN VERSION 2.02

Figure E1: RI Model for Pneumonia Patient Younger than 65, Using RIGLS PQL2

(a) Fixed Effect (b) Random Effect

Figure E2: Hypothesis Test for Intercept Term in the RI Model, Using RIGLS PQL2

Figure E3: Hypothesis Test for Black as Fixed Effect in the RI Model, Using RIGLS PQL2

Figure E4: RC Model for Pneumonia Patients Younger Than 65, Using RIGLS PQL2

(a) Fixed Effect (b) Random Effect

Figure E5: Hypothesis Test for Intercept Term in the RC Model, Using RIGLS PQL2

(a) Fixed Effect (b) Random Effect

Figure E6: Hypothesis Test for Black in the RC Model, Using RIGLS PQL2

Figure E7: RI Model for Pneumonia Patient Younger Than 65 in Q2Q4, Using RIGLS PQL2

(a) Fixed Effect (b) Random Effect

Figure E8: Hypothesis Test for Intercept Term in the RI Model in Q2Q4, Using RIGLS PQL2

Figure E9: Hypothesis Test for Black as Fixed Effect in the RI Model in Q2Q4, Using RIGLS PQL2

Figure E10: RC Model for Pneumonia patients younger than 65 in Q2Q4, Using RIGLS PQL2

(a) Fixed Effect (b) Random Effect

Figure E11: Hypothesis Test for Intercept Term in RC Model in Q2Q4, Using RIGLS PQL2

(a) Fixed Effect (b) Random Effect

Figure E12: Hypothesis Test for Black in RC Model in Q2Q4, Using RIGLS PQL2

Figure E13: RI Model for Pneumonia Patients Younger Than 65, Using IGLS MQL1

(a) Fixed Effect (b) Random Effect

Figure E14: Hypothesis Test for Intercept Term in the RI Model, Using IGLS MQL1

Figure E15: Hypothesis Test for Black as Fixed Effect in the RI Model, Using IGLS MQL1

Figure E16: RC Model for Pneumonia Patient Younger than 65, Using IGLS MQL1

(a) Fixed Effect (b) Random Effect

Figure E17: Hypothesis Test for Intercept Term in the RC Model, Using IGLS MQL1

(a) Fixed Effect (b) Random Effect

Figure E18: Hypothesis Test for Black in the RC Model, Using IGLS MQL1

Figure E19: RI Model for Pneumonia Patients Younger Than 65 in Q2 to Q4, Using IGLS MQL1

(a) Fixed Effect (b) Random Effect

Figure E20: Hypothesis Test for Intercept Term in RI Model in Q2 to Q4, using IGLS MQL1

Figure E21: Hypothesis Test for Black as Fixed Effect in the RI Model in Q2 to Q4, Using IGLS MQL1

Figure E22: RC Model for Pneumonia Patient Younger than 65 in Q2 to Q4, Using IGLS MQL1

(a) Fixed Effect (b) Random Effect

Figure E23: Hypothesis Test for Intercept Term in RC Model in Q2 to Q4, Using IGLS MQL1

(a) Fixed Effect (b) Random Effect

Figure E24: Hypothesis Test for Black in RC Model in Q2 to Q4, Using IGLS MQL1

APPENDIX F

PROGRAM FOR SIMULATION STUDY