Table 4.

Impact of geography and hospital size on the association between hospital spending and inpatient mortality, 1999–2003

	Odds ratio of inpatient mortality between highest and lowest quintile of hospital spending [95% Confidence Interval]
	AMI	CHF	Stroke	GI bleed	Hip fracture	Pneumonia
Region
Southern California	0.979 [0.619–1.339]	0.854 [0.597–1.111]	0.793 [0.512–1.074]	0.809 [0.555–1.063]	0.927 [0.612–1.243]	0.738 [0.556–0.919]
Rest of California	0.821 [0.701–0.941]	0.797 [0.645–0.950]	0.831 [0.696–0.966]	1.035 [0.841–1.230]	0.966 [0.697–1.236]	0.818 [0.674–0.961]
p-value	0.390	0.707	0.806	0.177	0.847	0.503
Hospital size
Larger than median hospital	0.863 [0.701–1.026]	0.764 [0.599–0.928]	0.698 [0.507–0.890]	0.964 [0.765–1.164]	0.778 [0.454–1.101]	0.725 [0.577–0.874]
Smaller than median hospital	0.955 [0.737–1.173]	0.789 [0.640–0.938]	0.757 [0.570–0.945]	0.887 [0.594–1.180]	1.007 [0.677–1.338]	0.775 [0.596–0.955]
p-value	0.479	0.794	0.634	0.660	0.291	0.646

Notes: Table examines whether geography and hospital size modify the association between hospital spending and inpatient mortality. Odds ratios for geography and hospital size compare inpatient mortality spending between the highest and lowest quintile of hospital spending; e.g. odds ratio < 1 implies adjusted inpatient mortality was lower in hospitals in the top spending quintile compared to the lowest. Abbreviations: Acute myocardial infarction (AMI), congestive heart failure (CHF), gastrointestinal hemorrhage (GI bleed).