Table 2.

Thirty-Day Mortality for Admissions During TJC Survey Weeks vs Other Weeks

Factor	No.	30-d Mortality (%)
		Unadjusted			Adjusteda
		Survey Weeks		Absolute Difference	Absolute Difference (95% CI)	P Value
		Non-TJCb	TJC
All admissions	1 707 126	7.21	7.03	−0.18	−0.12 (−0.22 to −0.01)	.03
Teaching hospital status
Nonmajor	1 568 812	7.28	7.13	−0.16	−0.10 (−0.21 to 0.01)	.08
Major	136 693	6.41	5.93	−0.49	−0.38 (−0.74 to −0.03)	.04
CMS total performance score halves
Lower half	1 102 021	7.28	7.12	−0.16	−0.10 (−0.23 to 0.03)	.14
Upper half	561 730	7.11	6.86	−0.25	−0.16 (−0.34 to 0.01)	.07
Patient-expected mortality halvesc
Lower half	864 241	1.19	1.20	0.01	0.02 (−0.08 to 0.11)	.72
Upper half	842 885	13.37	13.08	−0.29	−0.19 (−0.35 to −0.03)	.02

Abbreviations: CMS, Centers for Medicare & Medicaid Services; TJC, The Joint Commission.

^aAdjusted results were estimated from logistic regression models comparing 30-d mortality outcomes between TJC survey weeks vs nonsurvey weeks, with separate models estimated for each subgroup. All models were adjusted for age, sex, race/ethnicity, Elixhauser comorbidity score, the presence of any of 11 chronic illnesses (reported in Table 1), and major diagnostic category for admission. All analyses used robust variance estimators to account for clustering of admissions within hospitals. Absolute percentage changes in mortality attributable to TJC surveys were estimated using a marginal standardization approach.

^bNon-TJC survey weeks were defined as the 6 weeks occurring 3 weeks before and 3 weeks after the week of the TJC survey.

^cExpected 30-d mortality was calculated using a logistic regression model including all patient characteristics in the entire 100% Medicare admission data set (eMethods in the Supplement), and patients were categorized as having mortality above or below the expected median.