Table 2.

Regression Results of ALCR on Hospital Quality: HCAHPS, Hospital Compare, Readmissions & TPS (n=2314)

Analysis of Association Between ALCR and Quality	HCAHPS Summary Star Rating			Hospital Compare Rating			Hospital-Wide All Cause Readmission Rate			Total Performance Score
	Adj R2 = 42.9%			Adj R2 = 20.5%			Adj R2 = 15.7%			Adj R2 = 24.5%
	β	S.E	Sig	β	S.E.	Sig	β	S.E.	Sig	β	S.E.	Sig
ALCR	−2.071	0.194	***	−2.861	0.311	***	0.193	0.237	–	−14.503	2.954	***
Number of discharges	0.003	0.003	–	0.010	0.004	*	−0.003	0.003	–	−0.030	0.04	–
Number of staffed beds	−0.572	0.155	***	−0.732	0.25	**	0.406	0.19	*	−10.564	2.37	***
Location (Rural)	0.200	0.046	***	−0.078	0.074	–	0.122	0.056	*	2.113	0.702	**
Average age of facility (Years)	−0.003	0.001	*	−0.003	0.002	–	−0.001	0.002	–	0.058	0.021	**
Bed utilization rate	−0.004	0.001	***	−0.001	0.001	–	0.002	0.001	*	−0.022	0.013	+
Average length of stay	−0.053	0.005	***	−0.025	0.008	**	−0.009	0.006	–	−1.048	0.078	***
Academic medical center	0.241	0.067	***	0.101	0.108	–	0.143	0.082	+	2.392	1.021	**
Sole community hospital	−0.082	0.049	+	−0.080	0.079	–	0.008	0.061	–	1.330	0.753	+
Competition (HHI)	0.081	0.059	–	−0.190	0.095	*	−0.398	0.073	***	−2.067	0.903	*
Government operated	−0.038	0.043	–	−0.242	0.069	***	0.069	0.053	–	−3.142	0.659	***
For profit	−0.648	0.039	***	−0.648	0.062	***	0.322	0.047	***	−2.577	0.591	***
Payor mix: Medicaid days	0.005	0.001	***	0.004	0.002	+	0.000	0.002	–	0.018	0.021	–
Payor mix: Medicare days	−0.003	0.002	–	−0.005	0.003	*	0.004	0.002	*	0.010	0.026	–
Case mix index (CMI)	0.844	0.053	***	0.758	0.085	***	−0.740	0.065	***	−3.521	0.811	***
Surgical CMI	−1.174	0.14	***	−1.391	0.225	***	−0.069	0.172	–	−16.313	2.137	***
Medical CMI	−0.246	0.042	***	−0.322	0.068	***	0.361	0.052	***	1.924	0.644	**
CC/MCC rate	−0.482	0.147	***	1.646	0.236	***	−0.162	0.18	–	11.359	2.24	***
Region 2 (NJ, NY, PA)	−0.383	0.079	***	−0.618	0.127	***	−0.027	0.096	–	−1.705	1.201	–
Region 3 (DE, KY, MD, NC, VA, WV, DC)	−0.038	0.083	–	−0.459	0.134	***	−0.231	0.102	*	0.458	1.267	–
Region 4 (AL, FL, GA, MS, SC, TN, PR)	−0.133	0.077	+	−0.571	0.123	***	−0.146	0.094	–	−1.642	1.168	–
Region 5 (IL, MI, IN, OH, WI)	−0.12	0.077	–	−0.266	0.123	*	−0.181	0.094	*	−0.851	1.171	–
Region 6 (IA, KS, MN, MO, NE, ND, SD)	0.013	0.082	–	−0.096	0.132	–	−0.504	0.101	***	2.373	1.257	+
Region 7 (AR, LA, OK, TX)	0.001	0.079	–	−0.353	0.127	**	−0.266	0.097	**	−1.721	1.21	–
Region 8 (AZ, CO, ID, MT, NM, UT, WY)	−0.106	0.087	–	−0.069	0.139	–	−0.678	0.106	***	1.231	1.323	–
Region 9 (AK, CA, HI, NV, OR, WA)	−0.227	0.079	**	−0.152	0.127	–	−0.366	0.09	***	3.577	1.206	**

Notes: + p < 0.1, * p < 0.05; ** p < 0.01; *** p < 0.001; Region 1 (CT, ME, MA, NH, RI, VT) is referent.

Abbreviations: ALCR, ALCR: Agency labor cost ratio; HCAHPS, Hospital Consumer Assessment of Healthcare Providers and Systems; TPS, Total performance score; HHI, Hirschman-Herfindahl Index; CMI, Case mix index; CC/MCC, Complication/comorbidity and major complication/comorbidity.