Table 3. Number of Hospitals in Categories of RSMRs and RSPs by Hospital Characteristics (Low or High Designation Based on the Median)a.
| Variable | No. (%) | P Value | ||||
|---|---|---|---|---|---|---|
| Low RSMR | High RSMR | Total | ||||
| Low RSP | High RSP | Low RSP | High RSP | |||
| Acute Myocardial Infarction | ||||||
| No. of hospitals | 886 | 1222 | 1229 | 892 | 4229 | NA |
| RSMR, median (IQR), % | 13.9 (13.4-14.1) | 13.7 (13.1-14.0) | 14.8 (14.5-15.2) | 14.8 (14.5-15.4) | NA | NA |
| RSP, median (IQR), $ | 21 009 (20 393-21 379) | 22 621 (22 005-23 483) | 20 925 (20 320-21 319) | 22 540 (21 992-23 408) | NA | NA |
| Teaching status | ||||||
| Teaching | 163 (19.3) | 329 (38.9) | 130 (15.4) | 224 (26.5) | 846 (100) | <.001 |
| Nonteaching | 723 (21.4) | 893 (26.4) | 1099 (32.4) | 668 (19.7) | 3383 (100) | |
| Type of ownership | ||||||
| Private for-profit | 129 (18.5) | 219 (31.5) | 167 (24.0) | 181 (26.0) | 696 (100) | <.001 |
| Private not-for-profit | 554 (21.0) | 809 (30.8) | 708 (27.0) | 555 (21.1) | 2626 (100) | |
| Public | 203 (22.4) | 194 (21.4) | 354 (39.0) | 156 (17.2) | 907 (100) | |
| Safety-net status | ||||||
| Safety-net hospital | 270 (22.2) | 284 (23.4) | 446 (36.7) | 216 (17.8) | 1216 (100) | <.001 |
| Non–safety-net hospital | 616 (20.4) | 938 (31.1) | 783 (26.0) | 676 (22.4) | 3013 (100) | |
| Urban/rural status | ||||||
| Urban | 654 (20.3) | 1026 (31.8) | 809 (25.1) | 733 (22.7) | 3222 (100) | <.001 |
| Rural | 232 (23.0) | 196 (19.5) | 420 (41.7) | 159 (15.8) | 1007 (100) | |
| No. of beds | ||||||
| 1-199 | 641 (22.0) | 713 (24.4) | 1027 (35.2) | 538 (18.4) | 2919 (100) | <.001 |
| 200-299 | 106 (19.6) | 200 (37.0) | 91 (16.8) | 144 (26.6) | 541 (100) | |
| 300-399 | 58 (18.4) | 117 (37.0) | 55 (17.4) | 86 (27.2) | 316 (100) | |
| 400-499 | 28 (15.9) | 70 (39.8) | 26 (14.8) | 52 (29.5) | 176 (100) | |
| ≥500 | 51 (18.7) | 122 (44.7) | 30 (11.0) | 70 (25.6) | 273 (100) | |
| Proportion of patients who are Medicaid beneficiaries, % | ||||||
| 0-10 | 201 (19.9) | 316 (31.3) | 316 (31.3) | 175 (17.4) | 1008 (100) | .002 |
| 11-20 | 432 (22.2) | 552 (28.4) | 555 (28.5) | 405 (20.8) | 1944 (100) | |
| 21-30 | 169 (18.7) | 251 (27.8) | 250 (27.7) | 233 (25.8) | 903 (100) | |
| >30 | 82 (22.2) | 103 (27.8) | 108 (29.2) | 77 (20.8) | 370 (100) | |
| Proportion of patients who are black | ||||||
| Quartile 1, lowest proportion | 111 (19.2) | 229 (39.6) | 99 (17.1) | 139 (24.0) | 578 (100) | <.001 |
| Quartile 2 | 94 (16.3) | 237 (41.0) | 110 (19.0) | 137 (23.7) | 578 (100) | |
| Quartile 3 | 110 (19.0) | 181 (31.3) | 116 (20.1) | 171 (29.6) | 578 (100) | |
| Quartile 4, highest proportion | 138 (23.9) | 153 (26.5) | 165 (28.5) | 122 (21.1) | 578 (100) | |
| Hospitals with 0 black patients | 433 (22.6) | 422 (22.0) | 739 (38.5) | 323 (16.8) | 1917 (100) | |
| Proportion of patients with low SES | ||||||
| Quartile 1, lowest proportion | 144 (19.4) | 279 (37.6) | 161 (21.7) | 159 (21.4) | 743 (100) | |
| Quartile 2 | 140 (18.9) | 271 (36.7) | 165 (22.3) | 163 (22.1) | 739 (100) | |
| Quartile 3 | 147 (19.8) | 226 (30.5) | 166 (22.4) | 202 (27.3) | 741 (100) | |
| Quartile 4, highest proportion | 183 (24.7) | 151 (20.4) | 262 (35.4) | 145 (19.6) | 741 (100) | |
| Hospitals with 0 patients with low SES | 272 (21.5) | 295 (23.3) | 475 (37.5) | 223 (17.6) | 1265 (100) | |
| Proportion of patients who are dually eligible for Medicare and Medicaid | ||||||
| Quartile 1, lowest proportion | 178 (19.2) | 353 (38.1) | 186 (20.1) | 210 (22.7) | 927 (100) | <.001 |
| Quartile 2 | 180 (19.6) | 277 (30.1) | 236 (25.7) | 227 (24.7) | 920 (100) | |
| Quartile 3 | 220 (21.9) | 243 (24.2) | 319 (31.7) | 224 (22.3) | 1006 (100) | |
| Quartile 4, highest proportion | 193 (23.1) | 212 (25.3) | 281 (33.6) | 151 (18.0) | 837 (100) | |
| Hospitals with 0 dually eligible patients | 115 (21.3) | 137 (25.4) | 207 (38.4) | 80 (14.8) | 539 (100) | |
| Heart Failure | ||||||
| No. of hospitals | 1037 | 1207 | 1212 | 1049 | 4505 | NA |
| RSMR, median (IQR), % | 11.1 (10.6-11.4) | 10.9 (10.1-11.3) | 12.5 (12.1-13.2) | 12.4 (12.0-13.1) | NA | NA |
| RSP, median (IQR), $ | 14 320 (13 804-14 762) | 16 256 (15 699-17 226) | 14 274 (13 670-14 720) | 15 984 (15 522-16 610) | NA | NA |
| Teaching status | ||||||
| Teaching | 151 (17.5) | 374 (43.4) | 111 (12.9) | 225 (26.1) | 861 (100) | <.001 |
| Nonteaching | 886 (24.3) | 833 (22.9) | 1101 (30.2) | 824 (22.6) | 3644 (100) | |
| Type of ownership | ||||||
| Private for-profit | 159 (21.4) | 249 (33.5) | 165 (22.2) | 170 (22.9) | 743 (100) | <.001 |
| Private not-for-profit | 591 (21.6) | 757 (27.7) | 728 (26.6) | 657 (24.0) | 2733 (100) | |
| Public | 287 (27.9) | 201 (19.5) | 319 (31.0) | 222 (21.6) | 1029 (100) | |
| Safety-net status | ||||||
| Safety-net hospital | 367 (27.0) | 303 (22.2) | 408 (30.0) | 283 (20.8) | 1361 (100) | <.001 |
| Non–safety-net hospital | 670 (21.3) | 904 (28.8) | 804 (25.6) | 766 (24.4) | 3144 (100) | |
| Urban/rural status | ||||||
| Urban | 727 (21.8) | 1019 (30.5) | 796 (23.8) | 798 (23.9) | 3340 (100) | <.001 |
| Rural | 310 (26.6) | 188 (16.1) | 416 (35.7) | 251 (21.5) | 1165 (100) | |
| No. of beds | ||||||
| 1-199 | 861 (27.0) | 634 (19.9) | 1029 (32.3) | 665 (20.9) | 3189 (100) | <.001 |
| 200-299 | 84 (15.4) | 196 (36.0) | 93 (17.1) | 171 (31.4) | 544 (100) | |
| 300-399 | 36 (11.4) | 146 (46.1) | 43 (13.6) | 92 (29.0) | 317 (100) | |
| 400-499 | 19 (10.7) | 81 (45.8) | 29 (16.4) | 48 (27.1) | 177 (100) | |
| ≥500 | 37 (13.5) | 148 (54.0) | 16 (5.8) | 73 (26.6) | 274 (100) | |
| Proportion of patients who are Medicaid beneficiaries, % | ||||||
| 0-10 | 277 (23.8) | 307 (26.4) | 306 (26.3) | 272 (23.4) | 1162 (100) | .01 |
| 11-20 | 458 (22.5) | 512 (25.1) | 560 (27.5) | 508 (24.9) | 2038 (100) | |
| 21-30 | 208 (22.5) | 262 (28.4) | 244 (26.4) | 209 (22.6) | 923 (100) | |
| >30 | 94 (24.9) | 124 (32.8) | 100 (26.5) | 60 (15.9) | 378 (100) | |
| Proportion of patients who are black | ||||||
| Quartile 1, lowest proportion | 132 (18.2) | 187 (25.8) | 202 (27.8) | 205 (28.2) | 726 (100) | <.001 |
| Quartile 2 | 128 (17.6) | 233 (32.1) | 156 (21.5) | 209 (28.8) | 726 (100) | |
| Quartile 3 | 130 (17.9) | 281 (38.7) | 138 (19.0) | 177 (24.4) | 726 (100) | |
| Quartile 4, highest proportion | 212 (29.2) | 248 (34.2) | 145 (20.0) | 120 (16.6) | 725 (100) | |
| Hospitals with 0 black patients | 435 (27.2) | 258 (16.1) | 571 (35.6) | 338 (21.1) | 1602 (100) | |
| Proportion of patients with low SES | ||||||
| Quartile 1, lowest proportion | 169 (18.8) | 248 (27.6) | 260 (28.9) | 222 (24.7) | 899 (100) | <.001 |
| Quartile 2 | 186 (20.7) | 237 (26.4) | 236 (26.3) | 239 (26.6) | 898 (100) | |
| Quartile 3 | 183 (20.4) | 311 (34.6) | 168 (18.7) | 236 (26.3) | 898 (100) | |
| Quartile 4, highest proportion | 280 (31.2) | 233 (25.9) | 247 (27.5) | 138 (15.4) | 898 (100) | |
| Hospitals with 0 patients with low SES | 219 (24.0) | 178 (19.5) | 301 (33.0) | 214 (23.5) | 912 (100) | |
| Proportion of patients who are dually eligible for Medicare and Medicaid | 203 (18.8) | 311 (28.8) | 282 (26.1) | 284 (26.3) | 1080 (100) | |
| Quartile 1, lowest proportion | 209 (19.4) | 278 (25.7) | 308 (28.5) | 285 (26.4) | 1080 (100) | <.001 |
| Quartile 2 | 233 (21.6) | 278 (25.7) | 294 (27.2) | 275 (25.5) | 1080 (100) | |
| Quartile 3 | 341 (31.6) | 289 (26.8) | 271 (25.1) | 179 (16.6) | 1080 (100) | |
| Quartile 4, highest proportion | 51 (27.6) | 51 (27.6) | 57 (30.8) | 26 (14.1) | 185 (100) | |
| Hospitals with 0 dually eligible patients | ||||||
| Pneumonia | ||||||
| No. of hospitals | 1084 | 1181 | 1170 | 1108 | 4543 | NA |
| RSMR, median (IQR), % | 10.6 (10.0-11.1) | 10.5 (9.8-11.0) | 12.6 (12.0-13.6) | 12.5 (11.9-13.4) | NA | NA |
| RSP, median (IQR), $ | 13 370 (12 757-13 815) | 15 087 (14 631-15 821) | 13 317 (12 649-13 797) | 15 118 (14 649-15 774) | NA | NA |
| Teaching status | ||||||
| Teaching | 190 (22.0) | 344 (39.9) | 118 (13.7) | 210 (24.4) | 862 (100) | <.001 |
| Nonteaching | 894 (24.3) | 837 (22.7) | 1052 (28.6) | 898 (24.4) | 3681 (100) | |
| Type of ownership | ||||||
| Private for-profit | 161 (21.4) | 226 (30.0) | 165 (21.9) | 201 (26.7) | 753 (100) | <.001 |
| Private not-for-profit | 672 (24.5) | 764 (27.9) | 669 (24.4) | 634 (23.1) | 2739 (100) | |
| Public | 251 (23.9) | 191 (18.2) | 336 (32.0) | 273 (26.0) | 1051 (100) | |
| Safety-net status | ||||||
| Safety-net hospital | 322 (23.2) | 272 (19.6) | 452 (32.6) | 339 (24.5) | 1385 (100) | <.001 |
| Non–safety-net hospital | 762 (24.1) | 909 (28.8) | 718 (22.7) | 769 (24.4) | 3158 (100) | |
| Urban/rural status | ||||||
| Urban | 778 (23.1) | 996 (29.6) | 767 (22.8) | 822 (24.4) | 3363 (100) | <.001 |
| Rural | 306 (25.9) | 185 (15.7) | 403 (34.2) | 286 (24.2) | 1180 (100) | |
| No. of beds | ||||||
| 1-199 | 834 (25.9) | 667 (20.7) | 1001 (31.1) | 721 (22.4) | 3223 (100) | <.001 |
| 200-299 | 108 (19.8) | 181 (33.2) | 93 (17.1) | 163 (29.9) | 545 (100) | |
| 300-399 | 50 (15.7) | 124 (39.0) | 40 (12.6) | 104 (32.7) | 318 (100) | |
| 400-499 | 38 (21.3) | 73 (41.0) | 20 (11.2) | 47 (26.4) | 178 (100) | |
| ≥500 | 54 (19.6) | 134 (48.7) | 16 (5.8) | 71 (25.8) | 275 (100) | |
| Proportion of patients who are Medicaid beneficiaries, % | ||||||
| 0-10 | 310 (26.1) | 303 (25.5) | 282 (23.7) | 295 (24.8) | 1190 (100) | <.001 |
| 11-20 | 489 (24.0) | 524 (25.7) | 521 (25.5) | 507 (24.8) | 2041 (100) | |
| 21-30 | 196 (21.2) | 247 (26.7) | 267 (28.9) | 215 (23.2) | 925 (100) | |
| >30 | 89 (23.2) | 105 (27.4) | 100 (26.1) | 89 (23.2) | 383 (100) | |
| Proportion of patients who are black | ||||||
| Quartile 1, lowest proportion | 169 (23.1) | 193 (26.4) | 206 (28.2) | 163 (22.3) | 731 (100) | .19 |
| Quartile 2 | 147 (20.1) | 237 (32.4) | 161 (22.0) | 186 (25.4) | 731 (100) | |
| Quartile 3 | 141 (19.3) | 270 (36.9) | 117 (16.0) | 203 (27.8) | 731 (100) | |
| Quartile 4, highest proportion | 166 (22.7) | 207 (28.3) | 156 (21.3) | 202 (27.6) | 731 (100) | |
| Hospitals with 0 black patients | 461 (28.5) | 274 (16.9) | 530 (32.7) | 354 (21.9) | 1619 (100) | |
| Proportion of patients with low SES | ||||||
| Quartile 1, lowest proportion | 237 (24.7) | 267 (27.8) | 240 (25.0) | 215 (22.4) | 959 (100) | <.001 |
| Quartile 2 | 217 (22.6) | 272 (28.3) | 238 (24.8) | 233 (24.3) | 960 (100) | |
| Quartile 3 | 204 (21.3) | 297 (31.0) | 199 (20.8) | 258 (26.9) | 958 (100) | |
| Quartile 4, highest proportion | 238 (24.8) | 203 (21.2) | 292 (30.5) | 225 (23.5) | 958 (100) | |
| Hospitals with 0 patients with low SES | 188 (26.6) | 142 (20.1) | 201 (28.4) | 177 (25.0) | 708 (100) | |
| Proportion of patients who are dually eligible for Medicare and Medicaid | ||||||
| Quartile 1, lowest proportion | 292 (26.3) | 341 (30.7) | 226 (20.4) | 250 (22.5) | 1109 (100) | <.001 |
| Quartile 2 | 249 (22.3) | 282 (25.3) | 301 (27.0) | 283 (25.4) | 1115 (100) | |
| Quartile 3 | 245 (21.8) | 264 (23.5) | 306 (27.2) | 309 (27.5) | 1124 (100) | |
| Quartile 4, highest proportion | 261 (24.1) | 271 (25.0) | 304 (28.0) | 249 (22.9) | 1085 (100) | |
| Hospitals with 0 dually eligible patients | 37 (33.6) | 23 (20.9) | 33 (30.0) | 17 (15.5) | 110 (100) | |
Abbreviations: IQR, interquartile range; NA, not applicable; RSMRs, risk-standardized mortality rates; RSPs, risk-standardized payments; SES, socioeconomic status.
a
Values are inflation adjusted to 2013 US dollars. For acute myocardial infarction, 4229 of 4339 hospitals (97.5%) were matched to American Heart Association data. For heart failure, 4505 of 4641 hospitals (97.1%) were matched to American Heart Association data. For pneumonia, 4543 of 4685 hospitals (97.0%) were matched to American Heart Association data. Percentages may not sum to 100 because of rounding. Data are number (percentage) unless otherwise indicated.