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In the context of private health care, an optimal allocation of the medical resources for seniors is commonly done by forecasting their life spans. Accounting for each subject's particularities is therefore indispensable, so the available data must be processed at an individual level. We use a large and unique dataset of insured parties aged 65 and older to appropriately relate the emergency care usage with mortality risk. Longitudinal and time\u2010to\u2010event processes are jointly modeled, and their underlying relationship can therefore be assessed. Such an application, however, requires some special features to also be considered. First, longitudinal demand for emergency services exhibits a nonnegative integer response with an excess of zeros due to the very nature of the data. These subject\u2010specific responses are handled by a zero\u2010inflated version of the hierarchical negative binomial model. Second, event times must account for the left truncation derived from the fact that policyholders must reach the age of 65 before they may begin to be observed. Consequently, a delayed entry bias arises for those individuals entering the study after this age threshold. Third, and as the main challenge of our analysis, the association parameter between both processes is expected to be age\u2010dependent, with an unspecified association structure. This is well\u2010approximated through a flexible functional specification provided by penalized B\u2010splines. The parameter estimation of the joint model is derived under a Bayesian scheme.<\/jats:p>","DOI":"10.1002\/sim.8767","type":"journal-article","created":{"date-parts":[[2020,10,26]],"date-time":"2020-10-26T14:20:06Z","timestamp":1603722006000},"page":"147-166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Bayesian joint model for zero\u2010inflated integers and left\u2010truncated event times with a time\u2010varying association: Applications to senior health care"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-6273","authenticated-orcid":false,"given":"Xavier","family":"Piulachs","sequence":"first","affiliation":[{"name":"Department of Econometrics University of Barcelona Barcelona 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