Appendix Table 4.

Risk-adjusted odds-ratio of inpatient mortality by hospital spending quintile for six major medical conditions, according to inclusion of indicator variables for hospital regions in addition to baseline factors, 1999–2003

Quintile of hospital spending	AMI	CHF	Stroke	GI bleed	Hip fracture	Pneumonia
Baseline factors only
2	0.996 [0.870–1.122]	0.969 [0.838–1.099]	0.927 [0.782–1.071]	0.990 [0.855–1.125]	0.844 [0.667–1.022]	0.962 [0.850–1.075]
3	0.921 [0.806–1.037]	0.816 [0.695–0.936]	0.761 [0.628–0.895]	0.854 [0.719–0.989]	0.773 [0.605–0.941]	0.827 [0.704–0.951]
4	0.928 [0.794–1.062]	0.802 [0.682–0.922]	0.777 [0.642–0.912]	0.873 [0.738–1.009]	0.740 [0.581–0.898]	0.797 [0.693–0.901]
5	0.862 [0.742–0.983]	0.737 [0.617–0.857]	0.693 [0.555–0.831]	0.900 [0.742–1.058]	0.836 [0.613–1.058]	0.729 [0.619–0.840]
Including indicator variables for hospital regions
2	1.042 [0.913–1.171]	1.010 [0.880–1.140]	0.912 [0.783–1.041]	1.003 [0.859–1.147]	0.860 [0.682–1.038]	0.958 [0.837–1.078]
3	0.984 [0.833–1.135]	0.903 [0.765–1.040]	0.798 [0.669–0.927]	0.929 [0.764–1.093]	0.809 [0.609–1.008]	0.853 [0.726–0.980]
4	0.991 [0.830–1.152]	0.880 [0.735–1.025]	0.811 [0.668–0.955]	0.911 [0.752–1.070]	0.762 [0.579–0.946]	0.823 [0.702–0.943]
5	0.927 [0.772–1.083]	0.804 [0.662–0.946]	0.741 [0.604–0.878]	0.942 [0.762–1.121]	0.810 [0.586–1.034]	0.745 [0.624–0.865]

Notes: This table explores whether including indicators for hospital referral region impact the estimated association between hospital spending and inpatient mortality. The top panel reports odds ratios of inpatient mortality from the baseline specification which adjusts for predicted mortality and a set of patient and hospital/region factors. The bottom panel reports odds ratios when indicators for hospital referral region are included as well. Hospital regions were defined by Dartmouth hospital referral regions. 95% confidence interval in brackets. Abbreviations: Acute myocardial infarction (AMI), congestive heart failure (CHF), gastrointestinal hemorrhage (GI bleed).