Table 3.
Sensitivity of Treatment Incremental Effects on Hospital Readmission to Alternative Sample, Instrument, and Control Function Specifications
| Nursing Intervention Only | Physician Intervention Only | Both Interventions | ||||
|---|---|---|---|---|---|---|
| Percentage Point Change (95% CI) | p Value | Percentage Point Change (95% CI) | p Value | Percentage Point Change (95% CI) | p Value | |
| LATE sample of 98,730 index stays and 21,076 hospital readmissions | −0.90 (−7.00, 5.21) | .77 | −0.92 (−8.12, 6.29) | .80 | −8.23 (−12.34, −4.12) | <.001 |
| LATT sample of 12,397 index stays and 2,732 hospital readmissions | — | — | −9.95 (−17.05, −2.85) | <.001 | ||
| LATU sample of 39,617 index stays and 8,355 hospital readmissions | −0.82 (−6.55, 4.92) | .78 | −0.85 (−7.60, 5.91) | .81 | −7.77 (−11.59, −3.95) | .006 |
| LATE sample with instrument modification | ||||||
| Omit hospital follow‐up rate instruments | 0.94 (−12.87, 14.76) | .89 | −15.47 (−35.17, 4.23) | .12 | −12.50 (−24.65, −0.36) | .044 |
| Omit index stay discharge day instruments | −2.86 (−9.58, 3.86) | .40 | −2.08 (−9.82, 5.66) | .53 | −8.24 (−13.01, −3.47) | .001 |
| Add interactions of hospital follow‐up rates | −2.48 (−9.21, 4.25) | .47 | −1.92 (−9.67, 5.83) | .63 | −8.45 (−13.17, −3.74) | <.001 |
| Add squared terms of residuals (quadratic control function) | −1.81 (−8.10, 4.47) | .57 | −1.13 (−8.51, 6.24) | .76 | −9.40 (−14.01, −4.75) | <.001 |
| LATE sample with index stay exclusions | ||||||
| Omit 3,114 critical access hospital discharges | 0.97 (−5.47, 7.42) | .77 | 0.82 (−6.86, 8.50) | .83 | −8.29 (−12.42, −4.17) | <.001 |
| Omit 7,222 discharges of persons <age 65 | −2.68 (−8.84, 3.48) | .39 | −3.44 (−10.71, 3.83) | .35 | −7.47 (−11.92, −3.01) | .001 |
| Omit 3,772 discharges where LOS ≤1 day or ≥30 days | −0.85 (−7.01, 5.32) | .79 | −0.86 (−8.24, 6.52) | .82 | −8.50 (−12.66, −4.33) | <.001 |
| LATE sample with follow‐up event exclusions | ||||||
| Omit 1,001 “planned” hospital readmissions | −0.01 (−6.14, 6.11) | .99 | −0.30 (−7.52, 6.91) | .93 | −8.93 (−12.74, −5.12) | <.001 |
| Omit 540 SNF and other facility admissions | −0.77 (−6.84, 5.29) | .80 | −0.85 (−7.99, 6.29) | .82 | −7.93 (−12.00, −3.86) | <.001 |
| LATE sample splitting hospice and death outcomes in the multinomial logit | −0.89 (−6.99, 5.22) | .78 | −0.95 (−8.16, 6.25) | .80 | −8.22 (−12.33, −4.11) | <.001 |
| LATE sample lengthening follow‐up period to 37 days (inclusion of 4,758 day 31–37 events) | −2.03 (−8.37, 4.30) | .53 | −2.10 (−9.68, 5.47) | .59 | −7.78 (−12.58, −2.95) | .002 |
Control function adjustment for endogenous treatment. Except where indicated: “hospital readmissions” include a relatively small number of admissions to other inpatient settings (e.g., SNFs); and the instruments are index hospital rates of early follow‐up for non–heart failure medical patients and day of the week of index hospital stay discharge (see Methods section).
LATE, local average treatment effects among all patients; LATT, local average treatment effects among patients receiving treatment; LATU = local average treatment effects among patients receiving neither treatment (untreated).
[Correction added on 15 August 2016, after first online publication: layout errors in Tables 1–3 have been corrected, and additional corrections in column and row descriptions in Table 2 have been incorporated.]