Table 2.

Associations of geographic dispersion with patient outcomes

Outcomes	Unadjusted		Adjusted*
	Estimate (95% CI)	P Value	Estimate (95% CI)	P Value	%
Primary outcome—subdistribution hazard ratio
Rate of discharge†	0.6 (0.6–0.7)	<0.001	0.8 (0.7–0.9)	0.001	—
Secondary outcomes—risk ratios
In-hospital mortality	3.5 (2.3–5.3)	<0.001	1.2 (0.9–1.6)	0.3	Localized: 8
					Dispersed: 10
Discharge to home	0.9 (0.8–0.9)	<0.001	0.95 (0.91–0.99)	0.03	Localized: 77
					Dispersed: 73
Discharge to skilled nursing facilities	1.7 (1.3–2.2)	<0.001	1.5 (1.1–2.0)	0.01	Localized: 11
					Dispersed: 16
90-d hospital readmissions	1.0 (0.8–1.1)	0.7	1.0 (0.8–1.1)	0.6	Localized: 33
					Dispersed: 31

Definition of abbreviation: CI = confidence interval.

^*Models were adjusted for: age, gender, race, ethnicity, insurance type, Elixhauser comorbidity scores, the Centers for Medicare and Medicaid Services four-level severity risk adjustment (based on admitting diagnosis, demographics, and comorbidities), admission diagnosis category (from International Classification of Diseases-9 and -10 codes), daily mean number of pulmonary service patients by hospital during the hospitalization, code status (full vs. any limitation on life-sustaining therapies), hospital admission source, intensive care unit as the ward admission source, season, and the patient’s hospital.

^†Estimated using a Fine and Gray competing risks model to account for the competing risk of death.