Exhibit 1: Performance measures; hypothesized changes for affiliating rural hospitals, compared to nonaffiliating ones; and data sources.
| Performance measure | Hypothesized change | Data source |
|---|---|---|
| Structure | ||
| Technology compositea | Decrease | AHA Annual Survey |
| Obstetric care services | Decrease | AHA Annual Survey |
| Rural health clinic | Increase | AHA Annual Survey |
| Primary care department | Increase | AHA Annual Survey |
| Utilization | ||
| Admissions | Decrease | AHA Annual Survey |
| Emergency department visits | Decrease | AHA Annual Survey |
| Outpatient visits (nonemergency) | Increase | AHA Annual Survey |
| Financial | ||
| Operating margin | Increase | HCRIS |
| Asset-to-liability ratio | Increase | HCRIS |
| Uncompensated or unreimbursed care as a percentage of operating costs | Decrease | HCRIS |
| Quality | ||
| Patient experience compositeb | Increase | Hospital Compare |
| 30-day hospitalwide all-cause unplanned readmissions | Decrease | Hospital Compare |
SOURCE Authors’ analysis. NOTES AHA is the American Hospital Association. HCRIS is the Healthcare Cost Report Information System.
a
A count of up to eleven types of advanced diagnostic imaging technologies available on-site.
b
A weighted sum of nine normalized measures of patient experience.