Table 1.
Medicare Markups and Unadjusted 30-day Mortality Rates, by Service Line
| Medicare Markup† | Unadjusted 30-day Mortality | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| 1997 | 2001 | 2005 | Change‡ | 1997 | 2001 | 2005 | Change‡ | # Discharges | |
| Surgical orthopedics | 0.243 | 0.086 | −0.046 | −0.290* | 0.023 | 0.021 | 0.017 | −0.006* | 1,657,663 |
| Cardiovascular surgery | 0.373 | 0.269 | 0.107 | −0.266* | 0.051 | 0.045 | 0.039 | −0.013* | 285,258 |
| General surgery | 0.335 | 0.227 | 0.086 | −0.249* | 0.066 | 0.061 | 0.059 | −0.007* | 1,344,890 |
| Neurosurgery | 0.327 | 0.243 | 0.080 | −0.247* | 0.045 | 0.044 | 0.045 | 0.000 | 283,607 |
| Thoracic surgery | 0.375 | 0.283 | 0.137 | −0.238* | 0.106 | 0.104 | 0.097 | −0.009* | 167,898 |
| Vascular surgery | 0.289 | 0.185 | 0.056 | −0.232* | 0.086 | 0.077 | 0.068 | −0.019* | 379,462 |
| Hematology | 0.259 | 0.153 | 0.030 | −0.230* | 0.077 | 0.071 | 0.065 | −0.013* | 174,511 |
| Pulmonology | 0.209 | 0.088 | −0.017 | −0.226* | 0.122 | 0.120 | 0.104 | −0.017* | 2,364,083 |
| General medicine | 0.213 | 0.088 | −0.002 | −0.215* | 0.118 | 0.111 | 0.131 | 0.012* | 745,356 |
| Urology | 0.243 | 0.176 | 0.036 | −0.207* | 0.017 | 0.018 | 0.019 | 0.002* | 449,785 |
| Psychiatry | 0.054 | −0.068 | −0.149 | −0.203* | 0.036 | 0.039 | 0.035 | −0.001 | 128,627 |
| All Discharges | 0.206 | 0.112 | 0.010 | −0.196* | 0.079 | 0.074 | 0.069 | −0.011* | 17,238,641 |
| Gynecology | 0.193 | 0.138 | 0.004 | −0.189* | 0.009 | 0.009 | 0.009 | 0.000 | 235,090 |
| Medical orthopedics | 0.113 | −0.018 | −0.074 | −0.187* | 0.058 | 0.060 | 0.059 | 0.000 | 449,764 |
| Endocrine | 0.165 | 0.045 | −0.015 | −0.181* | 0.090 | 0.090 | 0.076 | −0.014* | 562,080 |
| Oncology | 0.226 | 0.153 | 0.046 | −0.179* | 0.293 | 0.306 | 0.306 | 0.013* | 402,669 |
| Nephrology | 0.167 | 0.054 | −0.008 | −0.176* | 0.097 | 0.100 | 0.091 | −0.006* | 588,644 |
| Invasive cardiology | 0.309 | 0.315 | 0.139 | −0.170* | 0.019 | 0.017 | 0.014 | −0.005* | 1,030,647 |
| Gastroenterology | 0.159 | 0.074 | −0.006 | −0.165* | 0.052 | 0.051 | 0.047 | −0.005* | 1,521,025 |
| Otolaryngology | 0.143 | 0.080 | −0.015 | −0.158* | 0.014 | 0.014 | 0.015 | 0.001 | 139,987 |
| Cardiology | 0.141 | 0.071 | −0.005 | −0.146* | 0.078 | 0.069 | 0.066 | −0.012* | 3,155,906 |
| Neurology | 0.115 | 0.028 | −0.018 | −0.133* | 0.107 | 0.104 | 0.102 | −0.005* | 1,171,689 |
*
p ≤ .01.
†
National average markup of each service line and year, where Medicare Markup = (Reimbursement-Cost)/Cost.
‡
Difference between the 2005 and 1997 levels.
Source: Authors calculations using MEDPAR and Medicare Cost Reports (1997–2005).