Table 2:
Factors Associated with Financial Distress: For-Profit and Non-Profit Hospitals
| For-Profit | Non-Profit | |||
|---|---|---|---|---|
| No. Hospitals | 789 | 1,844 | ||
| No. Hospital-Years | 5,517 | 13,847 | ||
| Variable | aOR (95% CI) | P Value | aOR (95% CI) | P Value |
| Year | ||||
| 2012 | 0.81 (0.58 – 1.15) | .24 | 1.05 (0.8 – 1.37) | .72 |
| 2013 | 0.84 (0.60 – 1.19) | .33 | 0.91 (0.69 – 1.19) | .49 |
| 2014 | 0.71 (0.50 – 1.02) | .06 | 1.08 (0.82 – 1.43) | .57 |
| 2015 | 0.74 (0.52 – 1.06) | .10 | 1.23 (0.93 – 1.62) | .15 |
| 2016 | 0.65 (0.45 – 0.94) | .02 | 1.42 (1.06 – 1.89) | .02 |
| 2017 | 0.72 (0.50 – 1.04) | .08 | 1.36 (1.01 – 1.82) | .04 |
| 2018 | 0.87 (0.60 – 1.27) | .47 | 1.47 (1.09 – 1.98) | .01 |
| Rural | 1.43 (0.52 – 3.95) | .49 | 0.32 (0.14 – 0.74) | .01 |
| Teaching Hospital | 1.03 (0.62 – 1.71) | .91 | 1.21 (0.83 – 1.75) | .33 |
| Hospital Bed Size | ||||
| 1 – 99 | 1.00 [Reference] | 1.00 [Reference] | ||
| 100 – 199 | 0.97 (0.59 – 1.6) | .90 | 0.53 (0.36 – 0.79) | .002 |
| 200 – 299 | 1.11 (0.57 – 2.15) | .77 | 0.27 (0.16 – 0.45) | < .001 |
| ≥ 300 | 0.15 (0.06 – 0.37) | < .001 | 0.15 (0.08 – 0.27) | < .001 |
| Case Mix Index, quartile † | ||||
| Lowest | 1.00 [Reference] | 1.00 [Reference] | ||
| Second | 0.45 (0.30 – 0.67) | < .001 | 0.71 (0.52 – 0.95) | .02 |
| Third | 0.32 (0.20 – 0.51) | < .001 | 0.49 (0.33 – 0.72) | < .001 |
| Highest | 0.17 (0.10 – 0.29) | < .001 | 0.47 (0.29 – 0.76) | .002 |
| Occupancy, quartile ‡ | ||||
| Lowest | 1.00 [Reference] | 1.00 [Reference] | ||
| Second | 0.86 (0.60 – 1.23) | .42 | 0.54 (0.39 – 0.75) | < .001 |
| Third | 0.48 (0.30 – 0.77) | .002 | 0.36 (0.24 – 0.53) | < .001 |
| Highest | 0.38 (0.21 – 0.67) | .001 | 0.26 (0.17 – 0.40) | < .001 |
| Medicaid Payor Mix, quartile § | ||||
| Lowest | 1.00 [Reference] | 1.00 [Reference] | ||
| Second | 1.40 (0.97 – 2.01) | .07 | 1.39 (1.05 – 1.84) | .02 |
| Third | 1.29 (0.86 – 1.92) | .22 | 1.62 (1.19 – 2.21) | .002 |
| Highest | 1.62 (1.04 – 2.54) | .03 | 2.65 (1.87 – 3.77) | < .001 |
| Outpatient Mix, quartile ¶ | ||||
| Lowest | 1.00 [Reference] | 1.00 [Reference] | ||
| Second | 0.91 (0.61 – 1.35) | .64 | 0.48 (0.35 – 0.66) | < .001 |
| Third | 0.68 (0.42 – 1.10) | .12 | 0.29 (0.19 – 0.43) | < .001 |
| Highest | 0.75 (0.43 – 1.32) | .32 | 0.19 (0.12 – 0.32) | < .001 |
| Herfindahl-Hirschman Index | ||||
| Unconcentrated | 1.00 [Reference] | 1.00 [Reference] | ||
| Moderate Concentration | 1.38 (0.84 – 2.27) | .20 | 0.62 (0.41 – 0.92) | .02 |
| High Concentration | 0.90 (0.52 – 1.58) | .73 | 0.67 (0.44 – 1.07) | .07 |
| Intercepts | ||||
| Random Intercept Variance: Hospital | 7.86 (6.57 – 9.40) | 9.27 (8.16 – 10.52) | ||
| Random Intercept Variance: State | 0.58 (0.17 – 1.99) | 0.49 (0.25 – 0.97) | ||
| Overall Wald Chi-Square Test | 133.73** | 203.29** | ||
Abbreviations: aOR = adjusted odds ratio, CI = confidence interval
The median value in each quartile was 1.18 (lowest), 1.46 (second), 1.64 (third), and 2.14 (highest) in for-profits and 1.25 (lowest), 1.46 (second), 1.64 (third), 1.89 (highest) in non-profits.
Measured as inpatient days divided by bed days available. The median value in each quartile was 24% (lowest), 45% (second), 60% (third), and 75% (highest) within for-profits and 29% (lowest), 46%, 61%, and 75% (highest) within non-profits.
Measured as Medicaid revenue divided by operating revenue. The median value in each quartile was 2.1% (lowest), 7.2% (second), 11.1% (third), and 19.8% (highest) within for-profits and 3.4% (lowest), 7.2%, 11.1%, and 18.9% (highest) within non-profits.
Measured as outpatient revenue divided by total patient revenue. The median value in each quartile was 33% (lowest), 48% (second), 59% (third), and 73% (highest) within for-profits and 36% (lowest), 48%, 59%, and 72% (highest) within non-profits.
p value ≤ .001