Table 3.
Hazard ratios (HR) and 95% confidence intervals (CI) for the relationship between health maintenance organization (HMO) versus fee-for-service (FFS) membership and 30-day cause-specific rehospitalization (N=8,098)
|
HR and 95%CI for 30-day rehospitalization |
HR and 95%CI for 30-day rehospitalization
+ discharge destination |
|||||
|---|---|---|---|---|---|---|
| Clinical Classification System (CCS)* | CCS Level | Frequency (N = 8,098) | HR for HMO v. FFS patients** | 95 % CI | HR for HMO v. FFS patients**† | 95 % CI |
| Not rehospitalized | n/a | 4,211 | 1.00 | 1.00 | ||
| Acute cerebrovascular disease | 7.3.1 | 440 | 1.34 | (1.09, 1.65) | 1.31 | (1.07, 1.6) |
| Non-acute cerebrovascular disease | 7.3.2, 7.3.3, 7.3.4, 7.3.6 | 324 | 1.14 | (0.84, 1.54) | 1.10 | (0.81, 1.49) |
| Heart disease | 7.2 | 583 | 0.99 | (0.84, 1.17) | 1.01 | (0.85, 1.2) |
| Infections and aspiration pneumonia | 1, 8.1, 8.4, 9.1, 10.4.1, 12.1, 13.1 | 652 | 0.85 | (0.72, 1.02) | 0.88 | (0.74, 1.05) |
| Respiratory disease other than infection/aspiration and circulatory disease other than heart | 7.1, 7.4, 7.5, 8.2, 8.3, 8.5, 8.6, 8.8, 8.9 | 277 | 0.77 | (0.6, 0.98) | 0.76 | (0.59, 0.97) |
| Injury and poisoning | 16 | 247 | 1.06 | (0.83, 1.36) | 1.09 | (0.84, 1.39) |
| Symptoms, signs, and ill-defined conditions | 17 | 268 | 2.87 | (1.85, 4.46) | 2.45 | (1.65, 3.64) |
| Other | Remaining codes | 1,096 | 0.80 | (0.7, 0.9) | 0.80 | (0.7, 0.91) |
Category indicates primary diagnosis for first rehospitalization within 30 days of the index admission
Adjusted for age, female, race, Medicaid, % of the census block group aged 25+ with college degrees, % of persons in the census block group below the poverty line, geographic region, prior stroke, cardiac arrhythmias, congestive heart failure, chronic pulmonary disease, uncomplicated diabetes, complicated diabetes, hypertension, fluid and electrolyte disorders, valvular disease, peripheral vascular disorders, hypothyroidism, solid tumor without metastasis, deficiency anemias, depression, dementia, concurrent cardiac events, mechanical ventilation, gastrostomy tube, hemiplegia/hemiparesis, residual neurological deficit, and year of index hospitalization. Analyses were conducted on patients discharged alive within 30 days with the exclusion of 217 patients discharged to hospice and 30 patients discharged to other facilities.
Model also includes discharge destination