Managed care and inpatient mortality in adults: effect of primary payer

Table 3 Inpatient mortality for patients with private insurance, comparing managed care to fee-for-service plans, by patient age, 2009

Measure	Sample size for managed care and FFS	Patient characteristics^a			Patient + hospital characteristics^b			Patient characteristics + hospital fixed effects			Patient + hospital characteristics + county fixed effects
Measure	Sample size for managed care and FFS	OR	95% CI	Difference^c	OR	95% CI	Difference^c	OR	95% CI	Difference^c	OR	95% CI	Difference^c
Private managed care vs. private FFS, age <65 years
AMI	44,580	0.91	0.78, 1.05		0.91	0.79, 1.06		0.89	0.75, 1.06		0.89	0.75, 1.05
Stroke	28,713	0.87	0.77, 0.97	↓	0.90	0.80, 1.01		0.89	0.78, 1.01		0.87	0.77, 0.99	↓
Pneumonia	51,636	1.05	0.92, 1.20		1.02	0.90, 1.17		1.00	0.85, 1.17		1.01	0.88, 1.17
CHF	26,980	0.84	0.69, 1.03		0.81	0.66, 0.99	↓	0.83	0.66, 1.04		0.75	0.60, 0.94	↓
Private managed care vs. private FFS, age ≥65 years
AMI	8,864	0.80	0.67, 0.95	↓	0.82	0.69, 0.98	↓	<did not converge>			<did not converge>
Stroke	9,528	0.64	0.55, 0.73	↓	0.70	0.60, 0.81	↓	<did not converge>			<did not converge>
Pneumonia	13,047	0.73	0.62, 0.86	↓	0.73	0.62, 0.86	↓	<did not converge>			<did not converge>
CHF	16,066	0.52	0.45, 0.61	↓	0.56	0.47, 0.66	↓	<did not converge>			<did not converge>

Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CI, confidence interval; FFS, fee for service; OR, odds ratio
^aPatient characteristics were age, sex, All Patient Refined-Diagnosis Related Group (APR-DRG), and community income
^bHospital characteristics were bed size, ownership, teaching status, and urban/rural location
^cA down arrow indicates the mortality rate for managed care is significantly lower than FFS at p < 0.05. An up arrow indicates the mortality rate for managed care is significantly higher than FFS at p < 0.05
Source: Agency for Healthcare Research and Quality, Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project, State Inpatient Databases, 2009, from the following 11 states: Arizona, California, Connecticut, Massachusetts, Michigan, Minnesota, New Hampshire, Nevada, New York, Ohio, and Pennsylvania

ISSN: 1472-6963