TABLE A2.
Overall effect of CJR for all admissions (ED + urgent + elective)
| Outcomes | (1) | (2) | (3) |
|---|---|---|---|
| CJR (overall) | CJR (2016) | CJR (2017) | |
| Patient selection | |||
| Age | −0.092 (0.0944) | −0.076 (0.1865) | −0.107 (0.1125) |
| Female | −0.0016 (0.5509) | −0.00063 (0.8343) | −0.0025 (0.4878) |
| White | 0.0027 (0.0887) | 0.0036 (0.0656) | 0.0018 (0.2953) |
| Black | −0.0022 (0.0629) | −0.0025 (0.1064) | −0.0019 (0.1680) |
| Disabled | −0.0019 (0.2331) | −0.00044 (0.8464) | −0.0028 (0.0978) |
| CCI (mean) | 0.019 (0.1333) | 0.021 (0.1177) | 0.017 (0.2461) |
| CCI of 0 | −0.0066 (0.1006) | −0.0058 (0.2044) | −0.0074 (0.0958) |
| CCI of 1 | 0.0017 (0.5000) | 0.0004 (0.8997) | 0.0091 (0.3176) |
| CCI of 2 or higher | 0.0040 (0.2604) | 0.0045 (0.2405) | 0.0035 (0.3887) |
| Age 65–69 years | 0.0058 (0.0699) | 0.0053 (0.1091) | 0.0063 (0.1137) |
| Age 70–74 years | −0.00046 (0.8724) | −0.00022 (0.9472) | −0.00070 (0.8308) |
| Age 75–79 years | 0.000038 (0.9879) | −0.0016 (0.5853) | 0.0017 (0.5662) |
| Age 80–84 years | −0.0015 (0.3775) | −0.00065 (0.7761) | −0.0024 (0.2563) |
| Age 85 years or older | −0.0018 (0.3657) | −0.0011 (0.6692) | −0.0026 (0.2651) |
| Cost outcomes | |||
| Total 90‐day episode costs | −957*** (0.0000) | −886*** (0.0000) | −1029*** (0.0001) |
| SNF 90‐day costs | −436** (0.0064) | −353* (0.0185) | −519** (0.0030) |
| Inpatient costs (index procedure) | −137 (0.0683) | −112 (0.1701) | −162* (0.0326) |
| Outpatient 90‐day costs | 15.0 (0.1838) | 3.0 (0.8602) | 27.0* (0.0475) |
| Durable medical equipment 90‐day costs | −3.7 (0.4311) | −5.5 (0.2452) | −1.9 (0.7170) |
| Home health agency 90‐day costs | 13.1 (0.8972) | 32.2 (0.7347) | −6.0 (0.9563) |
| BPCI inpatient 90‐day costs | −375* (0.0200) | −417** (0.0061) | −334 (0.0634) |
| BPCI Part B 90‐day costs | −32.6 (0.2799) | −33.2 (0.2659) | −32.0 (0.3287) |
| Quality outcomes | |||
| 90‐day readmission (any reasons) | −0.0031 (0.0648) | −0.0036 (0.0901) | −0.0025 (0.2360) |
| Mortality (30 days) | −0.00080 (0.1511) | −0.00077 (0.2455) | −0.00082 (0.2542) |
| Mortality (90 days) | −0.00063 (0.4563) | −0.00088 (0.4010) | −0.00035 (0.7321) |
| PE | 0.00014 (0.8918) | 0.000093 (0.9373) | 0.00019 (0.8786) |
| DVT | 0.00018 (0.8935) | −0.00067 (0.6846) | 0.00104 (0.4862) |
| Volume | |||
| Length of stay (day) | −0.23 (0.1936) | −0.28 (0.1151) | −0.19 (0.3504) |
| Number of episode | −0.88 (0.1994) | −0.86 (0.2995) | −0.90 (0.1532) |
| SNF utilization | |||
| Discharge to SNF | −0.0093 (0.2740) | −0.0070 (0.3866) | −0.0116 (0.2243) |
| SNF duration (day) | −0.46* (0.0156) | −0.37* (0.0408) | −0.55** (0.0075) |
Note: Column 1 represents difference‐in‐differences estimates during the first 2 years of the CJR program. Columns 2 and 3 represent difference‐in‐differences estimates during the first year (2016) of the CJR program and the second year (2017) of the CJR program, respectively. For continuous variables (costs, length of stay, number of episodes, and Charlson Comorbidity Index [mean]), estimated coefficients represent a change in each unit. For binary outcomes (30‐day mortality, 90‐day mortality, 90‐day readmission rate, PE, DVT, female, White, Black, disabled, Charlson Comorbidity Index of 0, 1, and 2+, age between 65 and 69 years, age between 70 and 74 years, age between 75 and 79 years, age between 80 and 84 years, and age older than 85 years), they represent a percentage point (ppts) change.
Abbreviations: BPCI, bundled payment for care improvement; CCI, Charlson Comorbidity Index; CJR, Comprehensive Care for Joint Replacement; DVT, deep vein thrombosis; PE, pulmonary embolism; SNF, skilled nursing facilities.
p < 0.05; **p < 0.01; ***p < 0.001; p value in parenthesis.