Table 4.
Type of Match: | Inside the Same Hospital Risk-Factor Match+ |
Across-Hospital Risk- Factor Match |
Across-Hospital Procedure Match | ||||||
---|---|---|---|---|---|---|---|---|---|
SDs are provided for all continuous variables. Variables |
Matched Blacks N = 14,917 |
Matched Whites N = 14,917 |
P-value | All Blacks N = 18,861 |
Matched Whites N = 18,861 |
P-value | All Blacks N = 18,861 |
Matched Whites N = 18,861 |
P-value |
Hospital Characteristics | |||||||||
Resident-to-bed (R:B) ratio | |||||||||
% Major (RB > 0.25) | 21.2 | 21.2 | 1.0000 | 22.9 | 12.9 | <0.0001 | 22.9 | 13.4 | <0.0001 |
% Minor (0 < RB ≤ 0.25) | 30.1 | 30.1 | 29.6 | 24.5 | 29.6 | 24.8 | |||
% Non-teaching (RB = 0) | 48.6 | 48.6 | 47.2 | 62.5 | 47.2 | 61.7 | |||
% Unknown/Missing | 0.1 | 0.1 | 0.2 | 0.2 | 0.2 | 0.2 | |||
Bed Size | |||||||||
% Large (Size > 250) | 76.8 | 76.8 | 1.0000 | 76.1 | 64.0 | <0.0001 | 76.1 | 64.4 | <0.0001 |
% Medium (101≤ Size ≤ 250) | 19.5 | 19.5 | 19.8 | 27.1 | 19.8 | 26.8 | |||
% Small (Size ≤ 100) | 3.6 | 3.6 | 3.9 | 8.8 | 3.9 | 8.6 | |||
% Unknown/Missing | 0.1 | 0.1 | 0.2 | 0.2 | 0.2 | 0.2 | |||
Nurse-to-bed (N:B) Ratio* | |||||||||
% High (N:B > 1.0) | 49.2 | 49.2 | 1.0000 | 46.3 | 49.6 | <0.0001 | 46.3 | 50.7 | <0.0001 |
% Moderate (0.5 ≤ N:B ≤ 1.0) | 41.6 | 41.6 | 43.1 | 41.9 | 43.1 | 40.4 | |||
% Low (N:B ≤ 0.5) | 9.1 | 9.1 | 10.3 | 8.4 | 10.3 | 8.7 | |||
% Unknown/Missing | 0.1 | 0.1 | 0.2 | 0.2 | 0.2 | 0.19 | |||
Nurse Mix # | |||||||||
% Advanced Staff (mix > 90% RN) | 51.6 | 51.6 | 1.0000 | 49.7 | 47.5 | <0.0001 | 49.7 | 47.7 | <0.0001 |
% Moderate Staff (75% ≤ RN ≤ 90%) | 35.7 | 35.7 | 37.4 | 37.0 | 37.4 | 36.8 | |||
% Elementary Staff (mix < 75% RN) | 11.1 | 11.1 | 11.4 | 14.6 | 11.4 | 14.5 | |||
% Unknown/Missing | 1.7 | 1.7 | 1.6 | 0.9 | 1.6 | 1.0 | |||
Technology Index ϯ | |||||||||
% High Technology | 57.5 | 57.5 | 1.0000 | 56.1 | 51.9 | <0.0001 | 56.1 | 51.7 | < 0.001 |
%Unknown/Missing | 0.1 | 0.1 | 0.2 | 0.2 | 0.2 | 0.2 | |||
Type of Financial Control | |||||||||
% Not-for-profit | 79.2 | 79.2 | 1.0000 | 76.3 | 80.6 | <0.0001 | 76.3 | 80.9 | <0.0001 |
% Private | 8.0 | 8.0 | 9.7 | 7.2 | 9.7 | 7.3 | |||
% Government | 12.9 | 12.9 | 14.1 | 12.3 | 14.1 | 11.9 | |||
Urbanicity | |||||||||
% Urban | 91.9 | 91.9 | 1.0000 | 92.3 | 82.7 | <0.0001 | 92.3 | 82.8 | <0.0001 |
Racial Composition of Hospitals’ Patients | |||||||||
% Admitted to Hospitals > 30% Black | 12.5 | 12.5 | 1.0000 | 21.4 | 2.6 | <0.0001 | 21.4 | 2.3 | <0.0001 |
% Admitted to Hospitals 6-30% Black | 64.3 | 64.3 | 58.6 | 39.5 | 58.6 | 38.8 | |||
% Admitted to Hospitals < 6% Black | 23.2 | 23.2 | 20.0 | 57.9 | 20.0 | 58.9 | |||
Socioeconomic Status of Hospitals’ Patients (Overall, Census 2000 5-digit ZIP) | |||||||||
% Patients from ZIP ≥ 20% Below Poverty Line | 8.4 | 8.4 | 1.0000 | 14.4 | 4.4 | <0.0001 | 14.4 | 4.1 | <0.0001 |
% Patients from ZIP 10-20% Below Poverty Line | 50.6 | 50.6 | 49.4 | 44.9 | 49.4 | 44.9 | |||
% Patients from ZIP < 10% Below Poverty Line | 41.1 | 41.1 | 36.1 | 50.7 | 36.1 | 51.0 | |||
Surgeon Characteristics | |||||||||
Board-Certified (%) | |||||||||
Yes | 38.8 | 39.6 | 0.6549 | 38.5 | 38.8 | 0.0054 | 38.5 | 38.8 | 0.0704 |
No | 19.7 | 19.8 | 17.8 | 19.3 | 17.8 | 18.9 | |||
Missing | 41.4 | 40.5 | 43.7 | 41.9 | 43.7 | 42.4 | |||
Attending Surgeon Years Since Graduation | |||||||||
Number of years (mean) | 22.9 (10.5) |
23.0 (10.4) |
0.5349 | 23.1 (10.5) |
22.6 (10.2) |
<0.0001 | 23.1 (10.5) |
22.5 (10.2) |
<0.0001 |
% Missing | 2.0 | 1.6 | 2.7 | 1.4 | 2.7 | 1.8 | |||
Patient Socioeconomic Characteristics | |||||||||
Dual-eligible (%) | 32.5 | 15.0 | <0.0001 | 34.4 | 14.7 | <0.0001 | 34.4 | 12.5 | <0.0001 |
Usual Source of Primary Care (%) | 59.5 | 64.0 | <0.0001 | 58.2 | 64.8 | <0.0001 | 58.2 | 64.3 | <0.0001 |
Number of Health Care Encounters 2 to 8 Months Prior to Surgery (mean) | 4.1 (4.1) |
4.7 (4.5) |
<0.0001 | 4.0 (4.3) |
4.7 (4.6) |
<0.0001 | 4.0 (4.3) |
4.6 (4.5) |
<0.0001 |
Neighborhood Census Median Income ($, mean) | 38,703 (15,877) |
48,243 (18,113) |
<0.0001 | 34,821 (15,595) |
44,266 (17,682) |
<0.0001 | 34,821 (15,595) |
44,554 (18,072) |
<0.0001 |
Neighborhood Census Below Poverty Level (mean, %) | 18.2 (10.9) |
11.4 (8.4) |
<0.0001 | 18.9 (11.1) |
10.5 (7.3) |
<0.0001 | 18.9 | 10.4 (7.2) |
<0.0001 |
Neighborhood Census High School Grads (mean, %) | 74.9 (11.6) |
81.0 (11.0) |
<0.0001 | 74.1 (12.0) |
81.3 (10.1) |
<0.0001 | 74.1 (12.0) |
81.6 (10.0) |
<0.0001 |
Neighborhood Isolation Index^ (mean) | 0.61 (0.16) |
0.60 (0.17) |
<0.0001 | 0.63 (0.16) |
0.54 (0.21) |
<0.0001 | 0.63 (0.16) |
0.54 (0.21) |
<0.0001 |
Neighborhood Dissimilarity Index^^ (mean) | 0.68 (0.10) |
0.67 (0.10) |
<0.0001 | 0.68 (0.10) |
0.64 (0.11) |
<0.0001 | 0.68 (0.10) |
0.64 (0.11) |
<0.0001 |
P-values were calculated using the Chi-square test.
Data for hospital characteristics was taken from Medicare Providers of Service (POS) file for 2005, the midpoint of the study data used for matching. Surgeon characteristics were obtained from Medicare Physician Identification and Eligibility Records (MPIER).
In the Inside-Hospital Match, blacks and whites are always matched within the same hospital, so the distribution of hospitals in this match is identical.
Nurse-to-bed ratio is calculated by dividing the number of full-time equivalent (FTE) nurses (registered nurses and licensed practical nurses) by the total number of beds.
Nurse mix is the ratio of registered nurses to the number of full-time equivalent nurses.
High technology is noted as the presence of a burn unit, or the provision of coronary artery bypass graft (CABG) or organ transplantation at the hospital.
The isolation index is a measure of the likelihood of minorities and whites coming onto contact with each other (1 = lowest exposure of minorities to whites).
The dissimilarity index is a measure of the evenness of distribution of races- the proportion of minorities who would have to change locations for race to be evenly distributed (1 = complete segregation; 0 = complete integration).