This paper presents multi-level models that utilise the Coxian phase-type distribution in order to be able to include a survival component in the model. The approach is demonstrated by modelling patient length of stay and in-hospital mortality in geriatric wards in Italy. The multi-level model is used to provide a means of controlling for the existence of possible intra-ward correlations, which may make patients within a hospital more alike in terms of experienced outcome than patients coming

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... om different hospitals, everything else being equal. Within this multi-level model we introduce the use of the Coxian phasetype distribution to create a covariate that represents patient length of stay or stage (of hospital care). Results demonstrate that the use of the multi-level model for representing the in-patient mortality is successful and further enhanced by the inclusion of the Coxian phase-type distribution variable (stage covariate).