Table 1.
Comparison of Baseline Characteristics for Patients, Stratified by Discharge Status
| Characteristics, n (%) or Median [25th and 75th Percentiles] |
Overall (n=15 459) |
Discharged to SNF (n=3727) |
Discharged to Home (n=11 732) |
P Value* |
|---|---|---|---|---|
| Demographics | ||||
| Age, y | 80 [74–86] | 84 [78–88] | 79 [73–84] | <0.001 |
| Female | 8544 (55.3) | 2440 (65.5) | 6104 (52.0) | <0.001 |
| White race | 12 472 (80.7) | 3128 (83.9) | 9344 (79.6) | <0.001 |
| Medicaid payment source | 895 (5.8) | 251 (6.7) | 644 (5.5) | 0.005 |
| Medical history | ||||
| Atrial fibrillation, chronic or recurrent | 5235 (34.8) | 1344 (37.2) | 3891 (34.0) | <0.001 |
| Atrial flutter | 287 (1.9) | 73 (2.0) | 214 (1.9) | 0.558 |
| COPD or asthma | 4320 (28.7) | 1034 (28.6) | 3286 (28.7) | 0.943 |
| Diabetes, insulin–treated | 2352 (15.6) | 592 (16.4) | 1760 (15.4) | 0.139 |
| Diabetes, non–insulin–treated | 3571 (23.7) | 784 (21.7) | 2787 (24.3) | 0.001 |
| Hyperlipidemia | 5848 (38.8) | 1131 (31.3) | 4717 (41.2) | <0.001 |
| Hypertension | 10 970 (72.8) | 2603 (72.1) | 8367 (73.1) | 0.247 |
| Peripheral vascular disease | 1963 (13.0) | 484 (13.4) | 1479 (12.9) | 0.448 |
| CVA/TIA | 2307 (15.3) | 717 (19.9) | 1590 (13.9) | <0.001 |
| Anemia | 2669 (17.7) | 830 (23.0) | 1839 (16.1) | <0.001 |
| Dialysis, chronic | 440 (2.9) | 92 (2.5) | 348 (3.0) | 0.126 |
| Renal insufficiency, chronic | 2801 (18.6) | 726 (20.1) | 2075 (18.1) | 0.008 |
| Depression | 1423 (9.4) | 536 (14.8) | 887 (7.7) | <0.001 |
| Smoking | 1426 (9.2) | 242 (6.5) | 1184 (10.1) | <0.001 |
| Cardiac history | ||||
| Ischemic etiology for heart failure | 6732 (43.5) | 1363 (36.6) | 5369 (45.8) | <0.001 |
| Valvular heart disease | 1113 (7.4) | 281 (7.8) | 832 (7.3) | 0.301 |
| LVEF, % | 45 [30–55] | 46 [30–60] | 43 [30–55] | <0.001 |
| LVEF <40% | 5673 (36.7) | 1143 (30.7) | 4530 (38.6) | <0.001 |
| ICD | 1069 (7.1) | 151 (4.2) | 918 (8.0) | <0.001 |
| Pacemaker | 1573 (10.4) | 371 (10.3) | 1202 (10.5) | 0.703 |
| Vital sign-admission | ||||
| BMI, kg/m2 | 26.3 [22.5–31.3] | 25.6 [21.8–30.6] | 26.6 [22.7–31.6] | <0.001 |
| Heart rate, bpm | 81 [70–96] | 81 [70–96] | 80 [70–95] | 0.078 |
| Systolic blood pressure, mm Hg | 138 [119–158] | 134 [116–155] | 139 [120–159] | <0.001 |
| Labs at admission | ||||
| Serum sodium, mEq/L | 138 [135–141] | 138 [135–141] | 138 [135–141] | 0.207 |
| Hemoglobin, g/dL | 11.8 [10.5–13.2] | 11.4 [10.2–12.8] | 12.0 [10.6–13.3] | <0.001 |
| BNP, pg/mL | 767 [385–1520] | 836 [436–1690] | 741 [370–1470] | <0.001 |
| Serum creatinine, mg/dL | 1.3 [1.0–1.8] | 1.3 [1.0–1.8] | 1.3 [1.0–1.9] | 0.008 |
| BUN, mg/dL | 26 [18–38] | 28 [20–41] | 26 [18–37] | <0.001 |
| Troponin, ng/mL | 0.05 [0.03–0.11] | 0.06 [0.03–0.14] | 0.05 [0.03–0.10] | <0.001 |
| Hospital characteristics | ||||
| No. of beds | 355 [217–575] | 357 [211–575] | 353 [217–571] | 0.020 |
| Academic medical center designation | 7989 (51.7) | 2086 (56.0) | 5903 (50.3) | <0.001 |
| Region | <0.001 | |||
| Northeast | 4501 (29.1) | 1350 (36.2) | 3151 (26.9) | |
| Midwest | 3668 (23.7) | 934 (25.1) | 2734 (23.3) | |
| South | 5604 (36.3) | 1039 (27.9) | 4565 (38.9) | |
| West | 1586 (10.3) | 374 (10.0) | 1212 (10.3) | |
| Discharge data | ||||
| Length of stay, d | 5 [4–7] | 6 [4–9] | 5 [3–7] | <0.001 |
| Comfort measures only at discharge | 124 (1.3) | 75 (3.4) | 49 (0.7) | <0.001 |
| Discharge care performance measures | 124 (0.8) | 75 (2.0) | 49 (0.4) | <0.001 |
| Documentation of LV function (percentage of those eligible) | ||||
| Patients with LVSD and no documented contraindications to ACEI/ARB† |
14 292 (94.4) | 3322 (92.5) | 10 970 (95.0) | <0.001 |
| Prescribed ACEI/ARB at discharge among patients eligible for measure (percent of those eligible) |
4710 (30.5) | 912 (24.5) | 3798 (32.4) | <0.001 |
| Patients with LVSD and no documented contraindications to β–blockers |
4020 (85.4) | 722 (79.2) | 3298 (86.8) | <0.001 |
| Prescribed β–blockers at discharge among patients eligible for measure (percent of those eligible) |
5131 (33.2) | 1004 (26.9) | 4127 (35.2) | <0.001 |
| Patients with smoking history discharged with smoking cessation counseling (percent of those eligible) |
4638 (90.4) | 858 (85.5) | 3780 (91.6) | <0.001 |
SNF indicates skilled nursing facility; COPD, chronic obstructive pulmonary disease; CVA/TIA, cerebrovascular accident/transient ischemic attack; LVEF, left ventricular ejection fraction; ICD, implantable cardioverter-defibrillator; BMI, body mass index; BNP, b-type natriuretic peptide; BUN, blood urea nitrogen; and SD, systolic dysfunction.
*
P values were calculated by comparing only nonmissing row values.
†
CMS performance measures otherwise exclude patients discharged to SNF.