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Table 4 Inpatient mortality for patients with Medicare and private insurance, comparing managed care to fee-for-service plans using a stringent definition of health maintenance organization, 2009

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

Measure Sample size for managed care and FFS Patient characteristicsa Patient + hospital characteristicsb Patient characteristics + hospital fixed effects Patient + hospital characteristics + county fixed effects
OR 95% CI Differencec OR 95% CI Differencec OR 95% CI Differencec OR 95% CI Differencec
Medicare managed care vs. Medicare FFS
 AMI 61,159 0.97 0.91, 1.04   0.98 0.91, 1.04   1.01 0.94, 1.09   1.00 0.94, 1.08  
 Stroke 69,803 0.91 0.86, 0.97 0.96 0.90, 1.03   0.99 0.92, 1.06   0.98 0.92, 1.05  
 Pneumonia 114,515 0.99 0.94, 1.06   1.03 0.97, 1.09   0.99 0.92, 1.06   1.05 0.98, 1.12  
 CHF 157,794 0.90 0.84, 0.95 0.91 0.86, 0.97 <did not converge> 0.93 0.87, 0.99
Private managed care vs. private FFS
 AMI 27,577 0.86 0.74, 1.00   0.88 0.75, 1.02   <did not converge> 0.88 0.74, 1.05  
 Stroke 21,510 0.87 0.78, 0.98 0.88 0.78, 0.98 1.02 0.88, 1.18   0.93 0.82, 1.07  
 Pneumonia 33,573 0.95 0.83, 1.08   0.92 0.80, 1.05   0.96 0.80, 1.14   0.93 0.80, 1.08  
 CHF 22,926 0.66 0.56, 0.78 0.67 0.56, 0.79 <did not converge> <did not converge>
  1. Abbreviations: AMI, acute myocardial infarction; CHF, congestive heart failure; CI, confidence interval; FFS, fee for service; OR, odds ratio
  2. aPatient characteristics were age, sex, All Patient Refined-Diagnosis Related Group (APR-DRG), and community income
  3. bHospital characteristics were bed size, ownership, teaching status, and urban/rural location
  4. 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
  5. 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 3 states: California, New York, and Pennsylvania