Table III.
Hospital characteristics and performance by quality quartile
| Quartile 1 (n = 104) | Quartile 2 (n = 104) | Quartile 3 (n = 104) | Quartile 4 (n = 104) | P value | |
|---|---|---|---|---|---|
| Region | .343 | ||||
| Northeast | >37 (>35.6) | 39 (37.5) | 27 (26.0) | 33 (32.4) | |
| South | 22 (21.2) | 17 (16.3) | 29 (27.9) | 20 (19.6) | |
| Midwest | <11 (<10.6) | 11 (10.6) | <11 (<10.6) | 13 (12.7) | |
| West | 34 (32.7) | 37 (35.6) | >37 (>35.6) | 36 (35.3) | |
| Urban hospital | 104 (100.0) | >93 (>89.4) | 104 (100.0) | >93 (>89.4) | .257 |
| Rural hospital | 0 (0.0) | <11 (<10.6) | 0 (0.0) | <11 (<10.6) | |
| ACS cancer center | 81 (77.9) | 78 (75.0) | 70 (67.3) | 60 (57.7) | .007 |
| Cancer center affiliate | 18 (17.3) | 20 (19.2) | 25 (24.0) | 31 (29.8) | .136 |
| Medical school affiliation | .010 | ||||
| Major | 48 (46.2) | 36 (34.6) | 30 (28.8) | 20 (19.2) | |
| Graduate | 17 (16.3) | 19 (18.3) | 21 (20.2) | 20 (19.2) | |
| Limited or No Affiliation | 39 (37.5) | 49 (47.1) | 53 (50.9) | 64 (61.5) | |
| Bed size | .005 | ||||
| Small (<100) | <11 (<10.6) | <11 (<10.6) | <11 (<10.6) | 12 (11.5) | |
| Medium (100–299) | 29 (27.9) | 36 (34.6) | 37 (35.6) | 48 (46.2) | |
| Large (300+) | >64 (>61.5) | >57 (>54.8) | >56 (>53.8) | 44 (42.3) | |
| Procedure volume over study period, median (IQI) | 16.00 (11.00–31.25) | 14.50 (7.00–29.50) | 9.00 (4.00–21.75) | 4.00 (3.00–9.75) | < .001 |
| Procedure mix, mean % of total volume (SD) | |||||
| Partial thyroidectomy | 23.8% (16.8) | 24.2% (18.1) | 22.6% (20.1) | 28.5% (25) | .163 |
| Total thyroidectomy without neck dissection | 52.1% (21.2) | 52.9% (23.3) | 56.3% (26.8) | 51.0% (29) | .469 |
| Total thyroidectomy with neck dissection | 24.0% (19.1) | 22.9% (19.1) | 21.2% (23.7) | 20.5% (23.6) | .617 |
| P:E ratio | 0.582 (0.154) | 1.058 (0.121) | 1.480 (0.132) | 2.373 (0.521) | < .001 |
| Risk-standardized adverse event risk, mean (SD) | 13.9% (4.3) | 25.1% (5.8) | 35.5% (7.4) | 52.9% (11.1) | < .001 |
Results are presented as n (%). Of the 843 hospitals assessed, 427 hospitals accounting for 11.8% (n = 850) of the patients in the training cohort were ineligible for inclusion in the simulation analysis due to perfectly predicting serious adverse event rates, either through having a 100% or 0 complication rate. Due to restrictions of the data use agreement, cell counts greater than 0 and less than 11 are depicted as <11.
ACS, American College of Surgeons; IQI, interquartile interval; P:E, predicted-to-expected.