Model-based two-way clustering of second-level units in ordinal multilevel latent Markov models

In this paper, an ordinal multilevel latent Markov model based on separate random effects is proposed. In detail, two distinct second-level discrete effects are considered in the model, one affecting the initial probability vector and the other affecting the transition probability matrix of the first-level ordinal latent Markov process. To model these separate effects, we consider a bi-dimensional mixture specification that allows to avoid unverifiable assumptions on the random effect distribution and to derive a two-way clustering of second-level units. Starting from a general model where the two random effects are dependent, we also obtain the independence model as a special case. The proposal is applied to data on the physical health status of a sample of elderly residents grouped into nursing homes. A simulation study assessing the performance of the proposal is also included.