  Modeling disease progression in healthcare administrative databases is
complicated by the fact that patients are observed only at irregular intervals
when they seek healthcare services. In a longitudinal cohort of 76,888 patients
with chronic obstructive pulmonary disease (COPD), we used a continuous-time
hidden Markov model with a generalized linear model to model healthcare
utilization events. We found that the fitted model provides interpretable
results suitable for summarization and hypothesis generation.
