Table 2. Subgroup Analyses of Safety-Net Hospitals by Lower vs Higher Baseline Operating Marginsa.
| Quality measure | Baseline operating margin | |||||
|---|---|---|---|---|---|---|
| Lower | Higher | |||||
| Unadjusted, mean (SD), % | Adjusted differential changeb | P value | Unadjusted, mean (SD), % | Adjusted differential changeb | P value | |
| Patient experience | ||||||
| Clean | 68.8 (6.9) | −0.08 | .89 | 70.4 (5.4) | −0.77 | .03 |
| Quiet | 56.7 (8.7) | −0.21 | .73 | 56.9 (7.6) | 0.18 | .57 |
| Nursing communication | 75.1 (5.5) | −0.18 | .76 | 77.4 (4.1) | −0.37 | .25 |
| Physician communication | 78.2 (4.3) | 0.29 | .48 | 78.5 (3.6) | 0.08 | .67 |
| Responsiveness | 60.9 (7.8) | −0.26 | .75 | 62.9 (5.8) | −1.07 | .02 |
| Communication on medications | 60.8 (5.7) | −0.41 | .45 | 62.1 (4.1) | −0.62 | .04 |
| Discharge information | 83.8 (4.2) | −0.03 | .95 | 85.6 (3.4) | −0.18 | .33 |
| Overall hospital rating | 66.0 (7.8) | 0.21 | .77 | 69.8 (6.9) | −0.61 | .09 |
| Health care-associated infections | ||||||
| CLABSI | 0.84 (0.68) | −0.10 | .29 | 0.72 (0.57) | 0.01 | .87 |
| CAUTI | 0.96 (0.72) | 0 | .99 | 0.85 (0.62) | 0.02 | .80 |
| SSI: colon surgery | 1.02 (0.84) | 0.24 | .03 | 0.87 (0.64) | 0.08 | .14 |
| Readmission | ||||||
| Acute MI | 17.2 (1.4) | −0.15 | .30 | 16.9 (1.4) | −0.20 | .22 |
| Heart failure | 22.8 (2.1) | −0.53 | .001 | 22.2 (2.0) | 0.15 | .45 |
| Pneumonia | 17.6 (1.5) | −0.13 | .17 | 17.2 (1.6) | −0.32 | .06 |
| Mortality | ||||||
| Acute MI | 14.1 (1.5) | 0.07 | .68 | 13.9 (1.5) | 0.19 | .20 |
| Heart failure | 11.4 (1.5) | −0.02 | .92 | 11.4 (1.7) | 0.36 | .02 |
| Pneumonia | 14.1 (2.8) | 0.14 | .63 | 13.9 (2.8) | 0.18 | .17 |
Abbreviations: CAUTI, catheter-associated urinary tract infection; CLABSI, central line–associated bloodstream infection; MI, myocardial infarction; SSI, surgical site infection.
a
Lower: 170 hospitals in nonexpansion states; 242 in expansion states; higher: 143 hospitals in nonexpansion states; 252 in expansion states.
b
Adjusted differential change represents the estimated percentage point difference between safety-net hospitals in expansion states compared to those in non-expansion states since the adoption of Medicaid expansion.