Table 2.
Hospital Characteristics | Designated Hospitalsa N=369 |
Other Hospitals a N=1,449 |
p-valueb |
---|---|---|---|
Structural Characteristicsc | |||
Number of Beds-- (% of hospitals) | |||
<100 | 2.4 | 20.4 | <0.01 |
100–400 | 56.6 | 63.2 | |
>400 | 40.9 | 16.5 | |
Region—(% of hospitals) | |||
West | 15.2 | 16.6 | 0.12 |
Midwest | 29.5 | 23.5 | |
South | 37.1 | 40.5 | |
Northeast | 18.2 | 19.4 | |
For profit (% of hospitals) | 13.3 | 22.0 | <0.01 |
Member of COTH (% of hospitals) | 31.2 | 8.6 | <0.01 |
Urban setting (% of hospitals) | 100.0 | 97.0 | <0.01 |
Medical/surgical ICU (% of hospitals)d | 98.5 | 90.6 | <0.01 |
Medicare insurance (average % of patients) | 42.2 | 43.9 | <0.01 |
Medicaid insurance (average % of patients) | 16.3 | 16.9 | 0.25 |
No. of nurses/1000 patient-days (average) | 6.9 | 8.9 | 0.12 |
All surgical operations – inpatient procedures per year (average) | 6,689 | 3,509 | <0.01 |
Patient Experience e (average percentage across all hospitals) | |||
Nurses “always” communicated well | 72.8 | 73.1 | 0.33 |
Doctors “always” communicated well | 77.3 | 78.4 | <0.01 |
Patient “always” received help as soon as they wanted it | 58.2 | 60.2 | 0.03 |
Pain was “always” well controlled | 66.9 | 67.5 | 0.12 |
Staff “always” explained medicines before giving it to them | 57.1 | 57.6 | <0.01 |
Room and bathroom were “always” clean | 64.8 | 67.3 | <0.01 |
Area around their room was “always” quiet at night | 52.1 | 54.7 | <0.01 |
Patients given information about what to do after discharge | 81.6 | 80.8 | <0.01 |
Rated hospital as 9 or 10 on a scale from 0 to 10 (highest) | 65.3 | 64.2 | 0.05 |
Definitely would recommend the hospital | 23.6 | 25.6 | <0.01 |
Surgical Quality of Care f (average percentage across hospitals) | |||
Patients given antibiotic within one hour before surgery | 95.2 | 93.5 | <0.01 |
Antibiotics stopped within 24 hours | 92.4 | 90.1 | <0.01 |
Patients given appropriate antibiotic | 97.6 | 96.7 | <0.01 |
Patients received appropriate timing of DVT prophylaxis | 92.8 | 89.2 | <0.01 |
Patients received DVT prophylaxis | 95.1 | 91.7 | <0.01 |
Patients received appropriate glucose control | 90.7 | 84.0 | <0.01 |
Patients received appropriate hair removal | 98.1 | 98.1 | 0.90 |
Patients on beta blockers continued on beta blockers | 90.1 | 89.1 | 0.16 |
Abbreviations: COTH= Council of Teaching Hospitals, ICU=intensive care unit, DVT=deep vein thrombosis
Hospitals included are those with at least one spine surgery during the study period (July 2007–September 2009).
Significant difference between designated hospitals and other hospitals based on a chi-square test or Satterthwaite t-test (P<.05).
Structural characteristics were derived from the 2008 American Hospital Association file. 5
Having an ICU was a requirement for designated hospitals; however, not all reported having an ICU to the AHA survey.
Patient experience measures were derived from the 2008 H-CAHPS survey data available on the Medicare Hospital Compare website.17
Surgical quality of care measures were derived from the 2008 Surgical Care Improvement Project (SCIP) data available on the Medicare Hospital Compare website.17