Table 5. Differential Changes in Hospital Use and Mortality.
| BPCI, % | Matched controls, % | Adjusted difference in differences (95% CI) | |||||
|---|---|---|---|---|---|---|---|
| Baseline period | Intervention period | Unadjusted difference | Baseline period | Intervention period | Unadjusted difference | ||
| ED use without admissiona | |||||||
| 30 d | 3.9 | 5.6 | 1.7 | 4.4 | 5.4 | 1.0 | 0.7 (−0.9 to 2.2) |
| 90 d | 12.4 | 16.0 | 3.6 | 12.7 | 14.5 | 1.8 | 1.8 (−0.7 to 4.3) |
| Inpatient readmission | |||||||
| 30 d | 8.8 | 9.0 | 0.1 | 9.0 | 9.6 | 0.5 | −0.4 (−1.4 to 0.6) |
| 90 d | 16.4 | 16.6 | 0.2 | 16.5 | 17.3 | 0.7 | −0.5 (−1.9 to 0.8) |
| Mortality | |||||||
| 30 d | 1.9 | 1.6 | −0.4 | 1.8 | 1.7 | −0.1 | −0.2 (−0.7 to 0.3) |
| 90 d | 4.5 | 3.6 | −0.9 | 4.6 | 4.1 | −0.5 | −0.4 (−1.2 to 0.4) |
Abbreviations: BPCI, Bundled Payment for Care Improvement; ED, emergency department; SNF, skilled nursing facility.
a
All estimates use standard errors clustered at the SNF level.
b
Adjusted estimates show the differential change in patient outcomes during the 90-day postadmission bundle period between treatment and control groups after vs before BPCI implementation. The differential change estimates can be interpreted as the average within-SNF change attributable to BPCI implementation.
c
ED visits without admission were defined using professional claims in the Medicare Part B carrier file, which was only available for a 20% random sample of patients.