Table 2.
Comparison of Good and Poor Outlier Hospitals
| Good (n=28) | Poor (n=12) | p-value | |
|---|---|---|---|
| Hospital Characteristics | |||
| SMR, mean (SD) | 0.5 (0.2) | 1.7 (0.3) | <0.001 |
| Teaching Hospital, n (%) | 6 (21.4%) | 3 (25.0%) | 1.00 |
| Trauma L1 or L2, n (%) | 5 (17.9%) | 3 (25.0%) | 0.68 |
| High tech capable, n (%) | 19 (67.9%) | 8 (66.7%) | 1.00 |
| Rural Location, n (%) | 1(3.6%) | 3 (25.0%) | 0.07 |
| >= 100 beds, n (%) | 26 (92.9%) | 10 (83.3%) | 0.57 |
| Hospital EGS operative volume, mean (SD) | 641.0 (399.2) | 788.3 (504.2) | 0.33 |
| Patient Characteristics (by hospital) | |||
| Age, mean (SD) | 51.0 (4.1) | 48.7 (4.5) | 0.12 |
| van Walraven score, mean (SD) | 2.6 (1.3) | 2.0 (1.1) | 0.17 |
| Hospital length of stay, mean (SD) | 5.3 (1.1) | 5.7 (1.5) | 0.35 |
| Proportion male, mean (SD) | 41.8% (3.9) | 41.4% (5.0) | 0.78 |
| Operative Characteristics (by hospita·) | |||
| Appendectomy, hospital mean (SD) | 198.6 (140.1) | 228.9 (158.4) | 0.55 |
| Cholecystectomy, hospital mean (SD) | 263.6 (159.1) | 366.3 (263.3) | 0.23 |
| Colectomy, hospital mean (SD) | 52.1 (41.0) | 53.8 (35.7) | 0.90 |
| Inguinal & Femoral Hernia, hospital mean (SD) | 12.8 (8.9) | 18.9 (12.2) | 0.08 |
| Lysis of Adhesion, hospital mean (SD) | 40.5 (35.4) | 34.8 (23.9) | 0.61 |
| Repair Perforated PUD, hospital mean (SD) | 7.6 (4.6) | 12.6 (6.4) | 0.01 |
| Small Bowel Resection, hospital mean (SD) | 28.7 (20.2) | 32.8 (22.0) | 0.57 |
| Ventral Hernia, hospital mean (SD) | 12.7 (8.4) | 18.2 (10.3) | 0.09 |
NOTE: “Good” outlier hospitals have a low SMR <1.0 with an 80% confidence interval upper bound that does not cross 1.0; “Poor” outlier hospitals have a high SMR > 1.0 with an 80% confidence interval lower bound that does not cross 1.0. For our Bayesian models of expected mortality, age, van Walraven score, gender, hospital volume, trauma center status, tech capability, and teaching hospital status were included in the model
SMR, risk-standardized mortality ratio; SD, standard deviation; n, number; L1, level 1 trauma center; L2, level 2 trauma center; EGS, emergency general surgery; PUD, peptic ulcer disease (including gastric and duodenal perforations)