Table 6.

Instrumental Variable Estimates of Intensive Management and Spending on Survival, by Surgical Intensity of Hospital Referral Region

	IV Estimates of
	Impact of CATH:		Impact of $1000:
Sample:	on 1-Year Survival	on 1-year Cost ($1000s)	on 1-year Survival
1. All patients
HRR risk-adjusted CATH rate:
a. Above the Median (n=63,771)	0.256 (0.061)	6.691 (3.510)	0.038 (0.021)
b. Below the Median (n=66,124)	0.09 (0.059)	9.835 (3.155)	0.009 (0.007)
Difference:	0.166 (0.085)	−3.144 (4.720)	0.029 (0.022)
2. Patients above the median CATH propensity
HRR risk-adjusted CATH rate:
a. Above the Median (n=32,388)	0.271 (0.064)	0.347 (4.370)	0.78 (9.820)
b. Below the Median (n=32,411)	0.168 (0.046)	4.962 (2.890)	0.034 (0.021)
3. Patients below the median CATH propensity
HRR risk-adjusted CATH rate:
a. Above the Median (n=31,383)	0.206 (0.129)	16.21 (5.130)	0.013 (0.009)
b. Below the Median (n=33,713)	−0.139 (0.165)	22.064 (6.870)	−0.006 (0.007)

Notes: HRR intensity rates are computed as the risk-adjusted fixed effects from a patient level regression the receipt of CATH or beta-blockers on HRR fixed effects and CCP risk-adjusters. Differential-distance (measured as the distance between the patient’s zip-code of residence and the nearest catheterization hospital minus the distance to the nearest hospital) is the instrument. Each model includes all the CCP risk-adjusters and the standard errors are clustered at the level of each HRR.