Table 4. Number of Hospitals in Categories of RSMRs and RSPs by Hospital Characteristics (Low or High Designation Based on Quartiles)a.
| Variable | No. (%) | P Value | ||||
|---|---|---|---|---|---|---|
| Low RSMR | High RSMR | Total | ||||
| Low RSP | High RSP | Low RSP | High RSP | |||
| Acute Myocardial Infarction | ||||||
| No. of hospitals | 219 | 443 | 396 | 261 | 1319 | NA |
| RSMR, median (IQR), % | 13.4 (12.9-13.6) | 13.2 (12.6-13.5) | 15.3 (15.0-15.8) | 15.4 (15.1-16.0) | NA | NA |
| RSP, median (IQR), $ | 20 305 (19 736-20 666) | 23 472 (22 992-24 303) | 20 255 (19 667-20 608) | 23 448 (22 953-24 286) | NA | NA |
| Teaching status | ||||||
| Teaching | 53 (14.5) | 167 (45.8) | 58 (15.9) | 87 (23.8) | 365 (100) | <.001 |
| Nonteaching | 166 (17.4) | 276 (28.9) | 338 (35.4) | 174 (18.2) | 954 (100) | |
| Type of ownership | ||||||
| Private for-profit | 32 (13.7) | 96 (41.2) | 55 (23.6) | 50 (21.5) | 233 (100) | <.001 |
| Private not-for-profit | 155 (17.3) | 321 (35.7) | 240 (26.7) | 182 (20.3) | 898 (100) | |
| Public | 32 (17.0) | 26 (13.8) | 101 (53.7) | 29 (15.4) | 188 (100) | |
| Safety-net status | ||||||
| Safety-net hospital | 53 (18.2) | 56 (19.2) | 136 (46.6) | 47 (16.1) | 292 (100) | <.001 |
| Non–safety-net hospital | 166 (16.2) | 387 (37.7) | 260 (25.3) | 214 (20.8) | 1027 (100) | |
| Urban/rural status | ||||||
| Urban | 195 (16.9) | 435 (37.7) | 282 (24.4) | 243 (21.0) | 1155 (100) | <.001 |
| Rural | 24 (14.6) | 8 (4.9) | 114 (69.5) | 18 (11.0) | 164 (100) | |
| No. of beds | ||||||
| 1-199 | 130 (18.2) | 169 (23.6) | 307 (42.9) | 109 (15.2) | 715 (100) | <.001 |
| 200-299 | 43 (17.4) | 113 (45.7) | 32 (13.0) | 59 (23.9) | 247 (100) | |
| 300-399 | 17 (12.1) | 58 (41.1) | 28 (19.9) | 38 (27.0) | 141 (100) | |
| 400-499 | 10 (13.0) | 31 (40.3) | 12 (15.6) | 24 (31.2) | 77 (100) | |
| ≥500 | 19 (13.7) | 72 (51.8) | 17 (12.2) | 31 (22.3) | 139 (100) | |
| Proportion of patients who are Medicaid beneficiaries, % | ||||||
| 0-10 | 31 (13.8) | 97 (43.1) | 60 (26.7) | 37 (16.4) | 225 (100) | .05 |
| 11-20 | 124 (18.9) | 203 (30.9) | 205 (31.2) | 125 (19.0) | 657 (100) | |
| 21-30 | 42 (13.8) | 102 (33.6) | 92 (30.3) | 68 (22.4) | 304 (100) | |
| >30 | 22 (16.5) | 41 (30.8) | 39 (29.3) | 31 (23.3) | 133 (100) | |
| Proportion of patients who are black | ||||||
| Quartile 1, lowest proportion | 43 (17.1) | 117 (46.4) | 45 (17.9) | 47 (18.7) | 252 (100) | <.001 |
| Quartile 2 | 24 (9.3) | 115 (44.7) | 53 (20.6) | 65 (25.3) | 257 (100) | |
| Quartile 3 | 37 (16.4) | 85 (37.6) | 39 (17.3) | 65 (28.8) | 226 (100) | |
| Quartile 4, highest proportion | 35 (17.8) | 60 (30.5) | 59 (29.9) | 43 (21.8) | 197 (100) | |
| Hospitals with 0 black patients | 80 (20.7) | 66 (17.1) | 200 (51.7) | 41 (10.6) | 387 (100) | |
| Proportion of patients with low SES | ||||||
| Quartile 1, lowest proportion | 49 (15.3) | 137 (42.7) | 76 (23.7) | 59 (18.4) | 321 (100) | <.001 |
| Quartile 2 | 46 (15.4) | 118 (39.5) | 67 (22.4) | 68 (22.7) | 299 (100) | |
| Quartile 3 | 48 (17.4) | 97 (35.1) | 64 (23.2) | 67 (24.3) | 276 (100) | |
| Quartile 4, highest proportion | 35 (17.2) | 48 (23.5) | 81 (39.7) | 40 (19.6) | 204 (100) | |
| Hospitals with 0 patients with low SES | 41 (18.7) | 43 (19.6) | 108 (49.3) | 27 (12.3) | 219 (100) | |
| Proportion of patients who are dually eligible for Medicare and Medicaid | ||||||
| Quartile 1, lowest proportion | 64 (16.2) | 170 (43.0) | 80 (20.3) | 81 (20.5) | 395 (100) | <.001 |
| Quartile 2 | 53 (15.6) | 117 (34.4) | 102 (30.0) | 68 (20.0) | 340 (100) | |
| Quartile 3 | 58 (17.2) | 91 (26.9) | 110 (32.5) | 79 (23.4) | 338 (100) | |
| Quartile 4, highest proportion | 36 (17.6) | 61 (29.9) | 75 (36.8) | 32 (15.7) | 204 (100) | |
| Hospitals with 0 dually eligible patients | 8 (19.0) | 4 (9.5) | 29 (69.0) | 1 (2.4) | 42 (100) | |
| Heart Failure | ||||||
| No. of hospitals | 231 | 420 | 338 | 223 | 1212 | NA |
| RSMR, median (IQR), % | 10.6 (10.1-10.8) | 10.1 (9.6-10.7) | 13.2 (12.8-13.9) | 13.1 (12.7-13.7) | NA | NA |
| RSP, median (IQR), $ | 13 783 (13 350-14 050) | 17 211 (16 617-17 916) | 13 624 (13 157-13 977) | 16 713 (16 342-17 287) | NA | NA |
| Teaching status | ||||||
| Teaching | 33 (12.3) | 161 (60.1) | 19 (7.1) | 55 (20.5) | 268 (100) | <.001 |
| Nonteaching | 198 (21.0) | 259 (27.4) | 319 (33.8) | 168 (17.8) | 944 (100) | |
| Type of ownership | ||||||
| Private for-profit | 37 (15.2) | 106 (43.6) | 45 (18.5) | 55 (22.6) | 243 (100) | <.001 |
| Private not-for-profit | 136 (18.8) | 269 (37.1) | 199 (27.4) | 121 (16.7) | 725 (100) | |
| Public | 58 (23.8) | 45 (18.4) | 94 (38.5) | 47 (19.3) | 244 (100) | |
| Safety-net status | ||||||
| Safety-net hospital | 83 (24.8) | 77 (23.0) | 117 (34.9) | 58 (17.3) | 335 (100) | <.001 |
| Non–safety-net hospital | 148 (16.9) | 343 (39.1) | 221 (25.2) | 165 (18.8) | 877 (100) | |
| Urban/rural status | ||||||
| Urban | 172 (17.8) | 398 (41.1) | 215 (22.2) | 183 (18.9) | 968 (100) | <.001 |
| Rural | 59 (24.2) | 22 (9.0) | 123 (50.4) | 40 (16.4) | 244 (100) | |
| No. of beds | ||||||
| 1-199 | 181 (23.7) | 161 (21.0) | 307 (40.1) | 116 (15.2) | 765 (100) | <.001 |
| 200-299 | 24 (13.9) | 84 (48.6) | 20 (11.6) | 45 (26.0) | 173 (100) | |
| 300-399 | 9 (8.5) | 65 (61.3) | 5 (4.7) | 27 (25.5) | 106 (100) | |
| 400-499 | 6 (10.9) | 35 (63.6) | 4 (7.3) | 10 (18.2) | 55 (100) | |
| ≥500 | 11 (9.7) | 75 (66.4) | 2 (1.8) | 25 (22.1) | 113 (100) | |
| Proportion of patients who are Medicaid beneficiaries, % | ||||||
| 0-10 | 52 (19.8) | 78 (29.8) | 78 (29.8) | 54 (20.6) | 262 (100) | .01 |
| 11-20 | 96 (17.8) | 186 (34.5) | 144 (26.7) | 113 (21.0) | 539 (100) | |
| 21-30 | 48 (17.1) | 103 (36.8) | 83 (29.6) | 46 (16.4) | 280 (100) | |
| >30 | 35 (26.7) | 53 (40.5) | 33 (25.2) | 10 (7.6) | 131 (100) | |
| Proportion of patients who are black | ||||||
| Quartile 1, lowest proportion | 52 (19.8) | 78 (29.8) | 78 (29.8) | 54 (20.6) | 262 (100) | <.001 |
| Quartile 2 | 96 (17.8) | 186 (34.5) | 144 (26.7) | 113 (21.0) | 539 (100) | |
| Quartile 3 | 48 (17.1) | 103 (36.8) | 83 (29.6) | 46 (16.4) | 280 (100) | |
| Quartile 4, highest proportion | 35 (26.7) | 53 (40.5) | 33 (25.2) | 10 (7.6) | 131 (100) | |
| Hospitals with 0 black patients | 73 (22.0) | 31 (9.3) | 172 (51.8) | 56 (16.9) | 332 (100) | |
| Proportion of patients with low SES | ||||||
| Quartile 1, lowest proportion | 35 (13.4) | 89 (34.1) | 89 (34.1) | 48 (18.4) | 261 (100) | <.001 |
| Quartile 2 | 39 (15.4) | 92 (36.2) | 70 (27.6) | 53 (20.9) | 254 (100) | |
| Quartile 3 | 44 (16.9) | 126 (48.5) | 34 (13.1) | 56 (21.5) | 260 (100) | |
| Quartile 4, highest proportion | 76 (29.5) | 94 (36.4) | 65 (25.2) | 23 (8.9) | 258 (100) | |
| Hospitals with 0 patients with low SES | 37 (20.7) | 19 (10.6) | 80 (44.7) | 43 (24.0) | 179 (100) | |
| Proportion of patients who are dually eligible for Medicare and Medicaid | ||||||
| Quartile 1, lowest proportion | 38 (13.7) | 96 (34.7) | 77 (27.8) | 66 (23.8) | 277 (100) | <.001 |
| Quartile 2 | 46 (14.7) | 95 (30.4) | 105 (33.5) | 67 (21.4) | 313 (100) | |
| Quartile 3 | 53 (18.9) | 101 (36.1) | 70 (25.0) | 56 (20.0) | 280 (100) | |
| Quartile 4, highest proportion | 93 (28.1) | 127 (38.4) | 77 (23.3) | 34 (10.3) | 331 (100) | |
| Hospitals with 0 dually eligible patients | 1 (9.1) | 1 (9.1) | 9 (81.8) | 0 (0.0) | 11 (100) | |
| Pneumonia | ||||||
| No. of hospitals | 249 | 318 | 324 | 280 | 1171 | NA |
| RSMR, median (IQR), % | 10.0 (9.6-10.3) | 9.8 (9.3-10.2) | 13.5 (13.0-14.3) | 13.5 (12.9-14.4) | NA | NA |
| RSP, median (IQR), $ | 12 763 (12 223-13 057) | 15 815 (15 436-16 490) | 12 653 (12 203-13 012) | 15 781 (15 369-16 416) | NA | NA |
| Teaching status | ||||||
| Teaching | 30 (15.2) | 106 (53.5) | 16 (8.1) | 46 (23.2) | 198 (100) | <.001 |
| Nonteaching | 219 (22.5) | 212 (21.8) | 308 (31.7) | 234 (24.0) | 973 (100) | |
| Type of ownership | ||||||
| Private for-profit | 30 (15.5) | 63 (32.5) | 42 (21.6) | 59 (30.4) | 194 (100) | <.001 |
| Private not-for-profit | 170 (23.8) | 226 (31.7) | 174 (24.4) | 144 (20.2) | 714 (100) | |
| Public | 49 (18.6) | 29 (11.0) | 108 (41.1) | 77 (29.3) | 263 (100) | |
| Safety-net status | ||||||
| Safety-net hospital | 69 (19.8) | 49 (14.1) | 143 (41.1) | 87 (25.0) | 348 (100) | <.001 |
| Non–safety-net hospital | 180 (21.9) | 269 (32.7) | 181 (22.0) | 193 (23.5) | 823 (100) | |
| Urban/rural status | ||||||
| Urban | 172 (20.2) | 285 (33.5) | 187 (22.0) | 206 (24.2) | 850 (100) | <.001 |
| Rural | 77 (24.0) | 33 (10.3) | 137 (42.7) | 74 (23.1) | 321 (100) | |
| No. of beds | ||||||
| 1-199 | 203 (24.5) | 150 (18.1) | 297 (35.9) | 177 (21.4) | 827 (100) | <.001 |
| 200-299 | 24 (15.8) | 65 (42.8) | 18 (11.8) | 45 (29.6) | 152 (100) | |
| 300-399 | 9 (11.1) | 36 (44.4) | 3 (3.7) | 33 (40.7) | 81 (100) | |
| 400-499 | 8 (17.8) | 21 (46.7) | 5 (11.1) | 11 (24.4) | 45 (100) | |
| ≥500 | 5 (7.6) | 46 (69.7) | 1 (1.5) | 14 (21.2) | 66 (100) | |
| Proportion of patients who are Medicaid beneficiaries, % | ||||||
| 0-10 | 60 (20.6) | 72 (24.7) | 71 (24.4) | 88 (30.2) | 291 (100) | .18 |
| 11-20 | 114 (21.6) | 146 (27.7) | 150 (28.4) | 118 (22.3) | 528 (100) | |
| 21-30 | 51 (20.5) | 67 (26.9) | 72 (28.9) | 59 (23.7) | 249 (100) | |
| >30 | 24 (23.3) | 33 (32.0) | 31 (30.1) | 15 (14.6) | 103 (100) | |
| Proportion of patients who are black | ||||||
| Quartile 1, lowest proportion | 40 (23.3) | 46 (26.7) | 54 (31.4) | 32 (18.6) | 172 (100) | <.001 |
| Quartile 2 | 36 (18.8) | 70 (36.5) | 41 (21.4) | 45 (23.4) | 192 (100) | |
| Quartile 3 | 21 (10.5) | 83 (41.5) | 31 (15.5) | 65 (32.5) | 200 (100) | |
| Quartile 4, highest proportion | 39 (19.3) | 69 (34.2) | 38 (18.8) | 56 (27.7) | 202 (100) | |
| Hospitals with 0 black patients | 113 (27.9) | 50 (12.3) | 160 (39.5) | 82 (20.2) | 405 (100) | |
| Proportion of patients with low SES | ||||||
| Quartile 1, lowest proportion | 68 (27.8) | 62 (25.3) | 57 (23.3) | 58 (23.7) | 245 (100) | <.001 |
| Quartile 2 | 48 (18.5) | 74 (28.6) | 72 (27.8) | 65 (25.1) | 259 (100) | |
| Quartile 3 | 46 (19.1) | 86 (35.7) | 41 (17.0) | 68 (28.2) | 241 (100) | |
| Quartile 4, highest proportion | 50 (18.7) | 71 (26.6) | 91 (34.1) | 55 (20.6) | 267 (100) | |
| Hospitals with 0 patients with low SES | 37 (23.3) | 25 (15.7) | 63 (39.6) | 34 (21.4) | 159 (100) | |
| Proportion of patients who are dually eligible for Medicare and Medicaid | ||||||
| Quartile 1, lowest proportion | 71 (26.7) | 81 (30.5) | 57 (21.4) | 57 (21.4) | 266 (100) | .04 |
| Quartile 2 | 62 (22.4) | 70 (25.3) | 76 (27.4) | 69 (24.9) | 277 (100) | |
| Quartile 3 | 58 (19.8) | 74 (25.3) | 84 (28.7) | 77 (26.3) | 293 (100) | |
| Quartile 4, highest proportion | 57 (17.6) | 92 (28.4) | 100 (30.9) | 75 (23.1) | 324 (100) | |
| Hospitals with 0 dually eligible patients | 1 (9.1) | 1 (9.1) | 7 (63.6) | 2 (18.2) | 11 (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, 1319 of 1332 hospitals (99.0%) were matched to American Heart Association data. For heart failure, 1212 of 1228 hospitals (98.7%) were matched to American Heart Association data. For pneumonia, 1171 of 1199 hospitals (97.7%) were matched to American Heart Association data. Percentages may not sum to 100 because of rounding. Data are number (percentage) unless otherwise indicated.