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An epidemiological model of the natural history of a disease within a multilevel care system.

Detailed epidemiological data on the entire course and treatment of illnesses requiring a variety of forms of management and various levels of institutionalization are scarce, probably due to the difficulty of assembling such data from a multiplicity of sources, particularly within complex and fragmented health care delivery systems. This paper described several analytic approaches to, and applications of, such a body of data, taken from a retrospective cohort study of 552 fractured hip cases incident in one year in an upstate New York county. Examples of six analytic applications of the data are presented, and emphasis is placed on the potential for practical use of some of the results.