Table 3. Mortality in the 30 Days After Admission and Hospital Mortality as a Function of the Number of Years of Experience of the 3860 Hospitalists Followed Over Their First 4 Years of Practicea.
| Characteristics | No. (%) | 30-Day Mortality Rate After Hospital Admission | Hospital Mortality Rate | ||
|---|---|---|---|---|---|
| Observed Rate, % | Odds Ratiob (95% CI) | Observed Rate, % | Odds Ratio (95% CI) | ||
| All | 83 831 | 10.21 | ND | 3.07 | ND |
| Age, y (mean SD) | 80.5 (7.96) | 10.21 | 1.05 (1.05-1.06) | 3.07 | 1.03 (1.02-1.04) |
| Sex | |||||
| Female | 54 061 (64.49) | 9.52 | 1 [Reference] | 2.81 | 1 [Reference] |
| Male | 29 770 (35.51) | 11.46 | 1.21 (1.15-1.27) | 3.53 | 1.14 (1.05-1.25) |
| Medicaid eligible | |||||
| No | 65 096 (77.65) | 10.17 | 1 [Reference] | 3.06 | 1 [Reference] |
| Yes | 18 735 (22.35) | 10.33 | 0.99 (0.94-1.06) | 3.08 | 0.92 (0.83-1.03) |
| Education (% of persons in zip code >25 years with high school education or higher [per percent]), mean (SD) | 86.4 (8.55) | 10.21 | 0.99 (0.99-1.01) | 3.07 | 0.99 (0.98-0.99) |
| Hospitalizations in 12 mo before admission (per hospitalization), mean (SD) | 1.3 (1.73) | 10.21 | 0.97 (0.96-0.99) | 3.07 | 0.95 (0.92-0.99) |
| Race | |||||
| White | 71 803 (85.65) | 10.34 | 1 [Reference] | 3.07 | 1 [Reference] |
| Black | 7050 (8.41) | 9.32 | 0.85 (0.77-0.93) | 3.06 | 0.94 (0.81-1.10) |
| Hispanic | 3173 (3.78) | 9.05 | 0.89 (0.78-1.03) | 2.80 | 0.90 (0.71-1.15) |
| Other | 1805 (2.15) | 10.47 | 1.06 (0.90-1.25) | 3.43 | 1.13 (0.87-1.48) |
| DRG type | |||||
| Medical | 66 203 (78.97) | 11.44 | 1 [Reference] | 3.28 | 1 [Reference] |
| Surgical | 17 628 (21.03) | 5.58 | 0.78 (0.71-0.84) | 2.26 | 1.26 (1.10-1.43) |
| Residence prior to hospitalization | |||||
| Community | 75 151 (89.65) | 9.55 | 1 [Reference] | 2.81 | 1 [Reference] |
| Nursing facility and other institutions | 8680 (10.35) | 15.89 | 1.62 (1.51-1.73) | 5.26 | 1.66 (1.48-1.86) |
| Bed size | |||||
| >500 | 21 189 (25.28) | 9.98 | 1 [Reference] | 3.21 | 1 [Reference] |
| 351-500 | 15 343 (18.30) | 10.13 | 0.99 (0.91-1.07) | 3.07 | 0.94 (0.83-1.09) |
| 201-350 | 24 536 (29.27) | 9.92 | 0.94 (0.87-1.02) | 3.01 | 0.91 (0.79-1.05) |
| ≤200 | 22 763 (27.15) | 10.79 | 1.00 (0.92-1.09) | 2.99 | 0.87 (0.75-1.03) |
| Urban/rural indicator | |||||
| Rural | 12 739 (15.20) | 11.34 | 1 [Reference] | 3.52 | 1 [Reference] |
| Urban | 71 092 (84.80) | 10.01 | 0.90 (0.83-0.97) | 2.98 | 0.82 (0.72-0.94) |
| Type of provider | |||||
| For profit | 11 849 (14.13) | 10.26 | 1 [Reference] | 3.03 | 1 [Reference] |
| Government | 9714 (11.59) | 10.76 | 1.02 (0.92-1.13) | 3.21 | 1.01 (0.85-1.21) |
| Nonprofit | 62 268 (74.28) | 10.11 | 0.93 (0.86-1.01) | 3.05 | 0.94 (0.83-1.08) |
| Medical school affiliation | |||||
| Major | 16 213 (19.34) | 9.55 | 1 [Reference] | 3.05 | 1 [Reference] |
| Limited | 15 211 (18.14) | 10.35 | 1.16 (1.06-1.27) | 3.06 | 1.06 (0.91-1.23) |
| Graduate | 4922 (5.87) | 11.19 | 1.24 (1.10-1.40) | 3.74 | 1.27 (1.04-1.57) |
| No affiliation | 47 485 (56.64) | 10.28 | 1.15 (1.06-1.24) | 3.00 | 1.06 (0.92-1.22) |
| Hospitalist experience | |||||
| First year | 18 370 (21.91) | 10.51 | 1 [Reference] | 3.33 | 1 [Reference] |
| Second year | 22 263 (26.56) | 9.97 | 0.90 (0.84-0.96) | 2.96 | 0.85 (0.76-0.95) |
| Third year | 22 395 (26.71) | 10.19 | 0.89 (0.84-0.96) | 3.11 | 0.86 (0.77-0.97) |
| Fourth year | 20 809 (24.82) | 10.23 | 0.89 (0.83-0.95) | 2.90 | 0.79 (0.69-0.88) |
Abbreviations: DRG, Diagnosis-Related Group; ND, no data.
a
The 83 831 admissions in this 5% sample represent a total of 1 676 620 admissions cared for by the 3860 hospitalists over their first 4 years working as hospitalists.
b
Odds ratio are from a multilevel model adjusted for all characteristics presented in the Table, as well as patient comorbidities and DRG-Major Diagnostic Category.