Table 1.
Unadjusted Average Process Compliance by Pay-for-Performance (P4P) and Public-Reporting-Only Hospitals, Fiscal Years 2003–2005
| P4P Hospitals | Reporting Early Adopters | Public-Reporting Only | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Year 1 | Year 3 | Gain | Year 1 | Year 3 | Gain | Year 1 | Year 3 | Gain | |
| AMI easy composite | 93.3 | 96.5 | 3.2 | 92.5 | 95.5 | 3.0 | 91.9 | 95.3 | 3.4 |
| (4.8) | (3.0) | (6.1) | (3.9) | (6.7) | (4.1) | ||||
| Aspirin at arrival (E) | 95.0 | 97.2 | 2.2 | 94.7 | 96.5 | 1.8 | 94.5 | 96.4 | 1.9 |
| (4.3) | (2.9) | (5.1) | (3.4) | (5.1) | (3.4) | ||||
| Aspirin at discharge (E) | 94.1 | 96.8 | 2.6 | 92.9 | 95.5 | 2.6 | 92.2 | 95.2 | 3.0 |
| (6.6) | (4.3) | (8.1) | (5.2) | (9.1) | (5.8) | ||||
| β-Blockers at arrival (E) | 79.6 | 88.5 | 8.8 | 89.9 | 93.6 | 3.7 | 78.2 | 85.3 | 7.1 |
| (14.2) | (10.7) | (9.2) | (5.5) | (17.9) | (11.6) | ||||
| β-Blockers at discharge (E) | 92.5 | 96.8 | 4.2 | 91.2 | 95.6 | 4.5 | 90.2 | 95.2 | 5.0 |
| (6.8) | (3.7) | (8.8) | (4.8) | (9.6) | (5.3) | ||||
| ACE-inhibitors for LVSD (difficult measure) | 90.7 | 94.9 | 4.2 | 79.2 | 86.0 | 6.7 | 89.1 | 93.4 | 4.3 |
| (7.2) | (4.3) | (16.9) | (11.2) | (9.8) | (5.6) | ||||
| Heart failure (HF) easy composite | 59.1 | 78.3 | 19.2 | 53.3 | 72.3 | 19.0 | 51.7 | 71.4 | 19.7 |
| (24.8) | (13.8) | (25.4) | (17.5) | (26.3) | (17.8) | ||||
| Discharge instructions (E) | 56.0 | 74.5 | 18.5 | 49.7 | 68.4 | 18.8 | 47.9 | 67.4 | 19.5 |
| (27.0) | (16.3) | (26.9) | (19.9) | (28.0) | (20.2) | ||||
| Smoking cessation advice (E) | 75.7 | 95.8 | 20.1 | 69.1 | 90.5 | 21.3 | 68.1 | 90.1 | 22.0 |
| (20.8) | (6.7) | (26.3) | (11.9) | (26.8) | (12.1) | ||||
| HF difficult composite | 86.2 | 93.5 | 7.3 | 85.0 | 91.6 | 84.3 | 91.1 | 6.8 | |
| (7.4) | (4.8) | (9.3) | (5.4) | (9.5) | (5.9) | ||||
| ACE-inhibitors for LVSD | 89.0 | 95.5 | 6.4 | 88.1 | 94.0 | 6.0 | 87.3 | 93.5 | 6.2 |
| (7.7) | (4.6) | (9.7) | (5.4) | (10.0) | (6.1) | ||||
| Left ventricular assessment | 78.5 | 88.2 | 9.8 | 76.2 | 85.5 | 9.4 | 75.8 | 85.1 | 9.3 |
| (12.2) | (8.3) | (14.0) | (8.6) | (14.2) | (9.1) | ||||
| Pneumonia easy composite | 98.9 | 99.8 | 0.9 | 98.8 | 99.7 | 0.9 | 98.7 | 99.7 | 1.0 |
| (2.1) | (0.5) | (2.7) | (0.7) | (2.6) | (0.8) | ||||
| Pneumonia vaccination status (E) | 51.6 | 80.9 | 29.3 | 43.3 | 71.9 | 28.6 | 42.1 | 70.6 | 28.5 |
| (24.3) | (13.0) | (25.8) | (18.0) | (25.5) | (18.8) | ||||
| Oxygenation assessment (E) | 98.9 | 99.8 | 0.9 | 98.8 | 99.7 | 0.9 | 98.7 | 99.7 | 0.9 |
| (2.1) | (0.5) | (2.7) | (0.7) | (2.6) | (0.8) | ||||
| Pneumonia difficult composite | 66.2 | 83.8 | 17.6 | 63.7 | 79.2 | 15.5 | 63.2 | 78.6 | 15.4 |
| (10.3) | (6.9) | (11.3) | (9.2) | (11.3) | (9.4) | ||||
| Blood culture preantibiotics | 83.4 | 92.1 | 8.6 | 82.3 | 89.9 | 7.6 | 82.3 | 89.7 | 7.4 |
| (7.8) | (5.4) | (9.5) | (6.4) | (9.8) | (6.5) | ||||
| Antibiotic timing | 68.7 | 80.3 | 11.6 | 68.5 | 77.4 | 8.8 | 68.3 | 77.0 | 8.6 |
| (9.5) | (7.6) | (11.6) | (10.3) | (11.6) | (10.3) | ||||
| % Medicare patient days | 0.51 | 0.50 | 0.50 | ||||||
| (0.11) | (0.13) | (0.13) | |||||||
| RN:patient ratio | 0.02 | 0.02 | 0.02 | ||||||
| (0.01) | (0.01) | (0.01) | |||||||
| Quality reporting | 0.78 | 0.76 | |||||||
| (0.41) | (0.43) | ||||||||
| Teaching hospital | 0.38 | 0.28 | 0.27 | ||||||
| (0.49) | (0.45) | (0.45) | |||||||
| Observations | 145 | 842 | 1,089 | ||||||
Note. Standard deviations in parentheses. (E) indicates easy tasks. Summary statistics of process compliance for P4P and public-reporting-only hospitals reporting on at least 30 patients with targeted admissions annually. Public-reporting column includes early adopters.
AMI, acute myocardial infarction; LVSD, left ventricular systolic dysfunction; RN, registered nurse.