Table 3.
Post-reform Year 1 X | Post-reform Year 2 X | |||||||
---|---|---|---|---|---|---|---|---|
Quartile 2a | Quartile 3a | Quartile 4a | Test of Between- Quartile Trend |
Quartile 2a | Quartile 3a | Quartile 4a | Test of Between- Quartile Trend |
|
Mortality | Odds Rat ios (95% CI )b |
Odds Ratios (95% CI )b |
||||||
Combined medical | 0.96 (0.92,1.01) |
1.02 (0.97,1.06) |
1.03 (0.98,1.08) |
1.01 (1.00,1.02) |
0.95* (0.91,0.99) |
0.99 (0.95,1.04) |
0.98 (0.94,1.03) |
0.99 (0.98,1.01) |
High-risk medical (vs. low-risk) |
0.98 (0.910,1.60) |
1.03 (0.95,1.11) |
0.95 (0.87,1.03) |
1.02 (0.99,1.04) |
0.97 (0.90,1.05) |
1.01 (0.93,1.09) |
1.02 (0.93,1.11) |
1.02 (0.99,1.05) |
Combinedsurgical | 0.98 (0.92,1.04) |
1.01 (0.95,1.07) |
0.97 (0.91,1.04) |
1.00 (0.98,1.01) |
0.92** (0.86,0.98) |
0.97 (0.91,1.04) |
0.97 (0.90,1.04) |
0.995 (0.98,1.01) |
High-risk surgical (vs. low-risk) |
0.94 (0.86,1.30) |
1.04 (0.95,1.35) |
0.96 (0.87,1.063) |
1.00 (0.97,1.03) |
0.98 (0.90,1.08) |
0.98 (0.89,1.07) |
1.04 (0.94,1.56) |
1.00 (0.97,1.025) |
Patient safety event | ||||||||
PSI-C | 0.97 (0.88,1.06) |
1.03 (0.93,1.13) |
0.97 (0.87,1.08) |
1.00 (0.97,1.03) |
0.91* (0.83,1.00) |
0.99 (0.90,1.09) |
0.94 (0.84,1.05) |
0.99 (0.97,1.02) |
PSI-T | 0.91* (0.82,1.00) |
0.95 (0.86,1.06) |
1.05 (0.94,1.17) |
1.00 (0.97,1.03) |
0.95 (0.86,1.05) |
0.95 (0.86,1.05) |
0.94 (0.84,1.05) |
0.97* (0.94,0.99) |
PSI-O | 0.93 (0.85,1.01) |
0.93 (0.85,1.01) |
0.88* (0.80,0.97) |
0.96** (0.94,0.99) |
0.89** (0.82,0.97) |
0.90* (0.82,0.98) |
0.95 (0.86,1.05) |
0.98 (0.96,1.01) |
FTR rate | 0.99 (0.93,1.05) |
1.02 (0.95,1.09) |
0.97 (0.90,1.04) |
1.00 (0.98,1.02) |
0.92** (0.86,0.98) |
0.97 (0.91,1.04) |
0.98 (0.91,1.06) |
1.00 (0.98,1.02) |
PLOS rate | ||||||||
Combined medical | 0.99 (0.96,1.02) |
1.02 (0.99,1.05) |
0.96* (0.93,0.99) |
1.00 (0.99,1.01) |
1.01 (0.98,1.04) |
1.00 (0.98,1.04) |
0.98 (0.95,1.01) |
1.00 (0.99,1.01) |
Combined surgical | 0.97 (0.93,1.01) |
1.04 (1.00,1.08) |
0.99 (0.95,1.04) |
1.01 (1.00,1.02) |
0.95** (0.91,0.99) |
1.01 (0.97,1.05) |
1.10*** (1.05,1.15) |
1.03*** (1.02,1.04) |
Abbreviation: CI, confidence interval; PSI, patient safety indicators; FTR, failure-to-rescue; PLOS, prolonged length of stay. High-risk samples include the top decile of patients by severity risk score.
The interaction terms (Post-reform Year 1 X Quartile 4) and (Post-reform Year 2 X Quartile 4) measure whether there is any relative change in the odds of the patient outcome in Quartile 4 (least financially healthy) vs. Quartile 1 (financially healthiest) hospitals. Analogous interaction terms for financial quartile 2 and 3 are also included. Models are also adjusted for age, sex, comorbidities, common time trends, and hospital site where treated.
Units for odds ratios compare hospitals in the quartile of interest to hospitals in Quartile 1, the financially healthiest quartile.
p<0.05,
p<0.01,
p<0.001