Table 7.
Relationship Between HRR Catheterization Rate, Survival and Costs, by Clinical Appropriateness for Intensive Management
| OLS Estimates of the Relationship Between HRR Risk-Adjusted CATH Rate and: | ||||
|---|---|---|---|---|
| Sample: | 1-Year Survival | 1-year Cost ($1000s) | Beta Blocker in Hospital | Catheterization within 30 days |
| 1. All patients (n=138,873) | 0.007 (0.019) | 8.093 (1.410) | −0.28 (0.073) | 0.702 (0.004) |
| 2. By CATH propensity | ||||
| a. Top Tercile (n=46,287) | 0.052 (0.019) | 10.012 (1.439) | −0.366 (0.073) | 0.802 (0.032) |
| b. Middle Tercile (n=46,295) | 0.03 (0.030) | 11.154 (1.784) | −0.271 (0.082) | 0.906 (0.021) |
| c. Bottom Tercile (n=46,291) | −0.075 (0.028) | 2.763 (1.612) | −0.209 (0.073) | 0.369 (0.021) |
| Difference (Top-Bottom): | 0.127 (0.034) | 7.249 (2.161) | −0.157 (0.103) | 0.433 (0.038) |
| 3. By age | ||||
| a. 65–80 (n=96,093) | 0.023 (0.021) | 9.616 (1.448) | −0.311 (0.072) | 0.775 (0.012) |
| b. Over 80 (n=42,780) | −0.031 (0.028) | 4.738 (1.603) | −0.215 (0.080) | 0.531 (0.022) |
| Difference (Top-Bottom): | 0.054 (0.035) | 4.878 (2.160) | −0.096 (0.108) | 0.244 (0.025) |
| 4. By AHA/ACC criterion | ||||
| a. Ideal (n=89,569) | 0.027 (0.023) | 9.845 (1.599) | −0.302 (0.076) | 0.769 (0.010) |
| b. Appropriate (n=31,800) | −0.002 (0.024) | 6.174 (1.537) | −0.282 (0.080) | 0.752 (0.026) |
| c. Not appropriate (n=17,504) | −0.08 (0.040) | 2.958 (1.511) | −0.177 (0.065) | 0.264 (0.021) |
| Difference (Top-Bottom): | 0.107 (0.046) | 6.887 (2.200) | −0.125 (0.100) | 0.505 (0.023) |
Notes: CATH propensity is an empirical measure of patient appropriateness for intensive treatments. We define this measure by using fitted values from a logit model of the receipt of cardiac catheterization on all the CCP risk-adjusters. HRR surgical and medical 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.