Table 2. Results of the interrupted time-series analysis (ITSA) on casemix index at Lebanese hospitals,adjusted for seasonality, 2011–2016, with the intervention point of August 2014 (two-month effect lag).
| a. Summary of changes | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Case type | Hospitals | Before intervention | After intervention | ||||||
| Monthly CMI
coefficient |
TREND | TREND | LEVEL | ||||||
| % (CI) | Explained by | % (CI) | Explained by | % (CI) | Explained by | ||||
| Medical | All | 0.975 | ➘0.10% (0.06 - 0.13%) |
Medium-stay
cases |
➚0.11% (0.02 - 0.21%) | Medium-stay cases | ⬆2.25% (0.51 - 3.98%) | Short-stay cases | |
| Public | 0.941 | ➘0.17% (0.11 - 0.23%) | ➚0.15% (0.06 - 0.22%) | - | - | - | |||
| Private | 0.989 | ➘0.06% (0.01 - 0.11%) | ➚0.19% (0.06 - 0.32%) | Short-stay cases | ⬆2.70% (0.15 - 5.24%) | Short-stay cases | |||
| Surgical | All | 1.284 | ➚0.05% (0.01 - 0.10%) | - | ➚0.14% (0.06 - 0.21%) 1 | - | - | - | |
| Public | 1.179 | - | No trend | ➚0.13% (0.02 - 0.24%) | - | - | - | ||
| Private | 1.326 | ➘0.12% (0.03 - 0.21%) | - | ➚0.24% (0.13 - 0.35%) 2 | - | - | - | ||
| Mixed | All | 1.783 | - | No trend | - | No trend | - | - | |
| Public | 1.964 | - | - | No trend | - | - | |||
| Private | 1.689 | - | ➚0.35% (0.10 - 0.60%) 3 | - | - | - | |||
| 1p=0.06, 2p=0.11, 3p=0.33; no significant change between pre and post-intervention | |||||||||
| b. Absolute changes in casemix index | |||||||||
| Hospitals | ITSA aspect | MEDICAL | SURGICAL | MIXED | |||||
| All stays | Short-stay | Medium-stay | Long-stay | All components | Medical component |
Surgical
component |
|||
| All | Starting level | 0.975 | 0.352 | 1.078 | 3.326 | 1.284 | 1.783 | 1.530 | 1.991 |
| Level at two
months post- intervention |
0.022 | 0.009 | - | 0.417 | - | - | - | - | |
| Monthly trend,
pre-intervention |
-0.001 | - | -0.001 | - | 0.001 | - | - | - | |
| Monthly trend,
post-intervention |
0.001 | 0.001 | 0.001 | - | 0.002 | - | - | - | |
|
Monthly trend,
change |
0.002 | 0.001 | 0.002 | - | - | - | - | - | |
| Public | Starting level | 0.941 | 0.356 | 1.049 | 2.697 | 1.179 | 1.964 | 1.708 | 2.200 |
| Level at
two months post- intervention |
- | 0.007 | - | - | - | - | - | - | |
| Monthly trend,
pre-intervention |
-0.002 | - | -0.001 | - | - | - | - | - | |
| Monthly trend,
post-intervention |
0.001 | - | 0.001 | - | 0.002 | - | -0.014 | - | |
|
Monthly trend,
change |
0.003 | - | 0.003 | - | 0.003 | - | - | - | |
| Private | Starting level | 0.989 | 0.352 | 1.089 | 3.498 | 1.326 | 1.689 | 1.421 | 1.906 |
| Level at two
months post- intervention |
0.027 | 0.009 | - | 0.489 | - | - | - | - | |
| Monthly trend,
pre-intervention |
-0.001 | - | - | - | 0.002 | - | - | - | |
| Monthly trend,
post-intervention |
0.002 | 0.001 | 0.002 | - | 0.003 | 0.006 | - | 0.008 | |
|
Monthly trend,
change |
0.003 | 0.001 | 0.002 | - | - | - | - | - | |
| (Numerating only results significant at p<0.05) | |||||||||
| c. Relative changes, using respective monthly casemix index starting level, percentages | |||||||||
| Hospitals | ITSA aspect | MEDICAL | SURGICAL | MIXED | |||||
| All stays | Short-stay | Medium-stay | Long-stay | All components | Medical component |
Surgical
component |
|||
| All | Starting level | 0.975 | 0.352 | 1.078 | 3.326 | 1.284 | 1.783 | 1.530 | 1.991 |
| Level at two
months post- intervention |
2.25% | 2.61% | - | 0.125 | - | - | - | - | |
| Monthly trend,
pre-intervention |
-0.10% | - | -0.06% | - | 0.05% | - | - | - | |
| Monthly trend,
post-intervention |
0.11% | 0.14% | 0.09% | - | 0.14% | - | - | - | |
|
Monthly trend,
change |
0.22% | 0.17% | 0.16% | - | - | - | - | - | |
| Public | Starting level | 0.941 | 0.356 | 1.049 | 2.697 | 1.179 | 1.964 | 1.708 | 2.200 |
| Level at two
months post- intervention |
- | 2.05% | - | - | - | - | - | - | |
| Monthly trend,
pre-intervention |
-0.17% | - | -0.12% | - | - | - | - | - | |
| Monthly trend,
post-intervention |
0.15% | - | 0.11% | - | 0.13% | - | -0.81% | - | |
|
Monthly trend,
change |
0.31% | - | 0.24% | - | 0.22% | - | - | - | |
| Private | Starting level | 0.989 | 0.352 | 1.089 | 3.498 | 1.326 | 1.689 | 1.421 | 1.906 |
| Level at two
months post- intervention |
2.70% | 2.56% | - | 13.98% | - | - | - | - | |
| Monthly trend,
pre-intervention |
-0.06% | - | - | - | 0.12% | - | - | - | |
| Monthly trend,
post-intervention |
0.19% | 0.23% | 0.15% | - | 0.24% | 0.35% | - | 0.41% | |
|
Monthly trend,
change |
0.25% | 0.28% | 0.18% | - | - | - | - | - | |
| d. Confidence intervals for table 2b. | |||||||||
| Hospitals | ITSA aspect | MEDICAL | SURGICAL | MIXED | |||||
| All stays | Short-stay | Medium-stay | Long-stay | All components | Medical component |
Surgical
component |
|||
| All | Starting level | 0.9599 - 0.9896 | 0.3416 - 0.3630 | 1.0498 - 1.1068 | 2.5017 - 4.1500 | 1.2666 - 1.3013 | 1.6649 - 1.9012 | 1.3860 - 1.6741 | 1.8782 - 2.1043 |
| Level at two
months post- intervention |
0.0050 - 0.0388 | 0.0031 - 0.0153 | - | 0.1414 - 0.6932 | - | - | - | - | |
| Monthly trend,
pre-intervention |
(0.0013 - 0.0006) | - | (0.0012 - 0.0003) | - | 0.0001 - 0.0013 | - | - | - | |
| Monthly trend,
post-intervention |
0.0002 - 0.0020 | 0.0002 - 0.0007 | 0.0002 - 0.0017 | - | 0.0008 - 0.0027 | - | - | - | |
|
Monthly trend,
change |
0.0012 - 0.0030 | 0.0002 - 0.0010 | 0.0008 - 0.0026 | - | - | - | - | - | |
| Public | Starting level | 0.9095 - 0.9723 | 0.3394 - 0.3728 | 1.0377 - 1.0593 | 1.3111 - 4.0834 | 1.0898 - 1.2691 | 1.7092 - 2.2188 | 1.5207 - 1.8947 | 1.8338 - 2.5664 |
| Level at two
months post- intervention |
- | 0.0012 - 0.0135 | - | - | - | - | - | - | |
| Monthly trend, pre-intervention | (0.0022 - 0.0010) | - | (0.0017 - 0.0010) | - | - | - | - | - | |
| Monthly trend,
post-intervention |
0.0006 - 0.0021 | - | 0.0009 - 0.0015 | - | 0.0002 - 0.0028 | - | (0.0254 - 0.0024) | - | |
|
Monthly trend,
change |
0.0019 - 0.0039 | - | 0.0020 - 0.0030 | - | 0.0007 - 0.0046 | - | - | - | |
| Private | Starting level | 0.9657 - 1.0117 | 0.3409 - 0.3628 | 1.0523 - 1.1258 | 2.7808 - 4.2154 | 1.2820 - 1.3702 | 1.6016 - 1.7767 | 1.2363 - 1.6055 | 1.8291 - 1.9833 |
| Level at two
months post- intervention |
0.0015 - 0.0518 | 0.0012 - 0.0169 | - | 0.1433 - 0.8347 | - | - | - | - | |
| Monthly trend,
pre-intervention |
(0.0011 - 0.0001) | - | - | - | 0.0004 - 0.0028 | - | - | - | |
| Monthly trend,
post-intervention |
0.0006 - 0.0032 | 0.0004 - 0.0013 | 0.0002 - 0.0030 | - | 0.0017 - 0.0047 | 0.0017 - 0.0101 | - | 0.0018 - 0.0139 | |
|
Monthly trend,
change |
0.0012 - 0.0038 | 0.0004 - 0.0016 | 0.0004 - 0.0035 | - | - | - | - | - | |
| (Numerating only results significant at p<0.05) | |||||||||