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Table 8 Association of HVBP with 30-day risk adjusted mortality rate for AMI, HF, and pneumonia using alternative cut-off point 60% to classify high and low Medicare share hospitals

From: Association between degree of exposure to the Hospital Value Based Purchasing Program and 30-day mortality: experience from the first four years of Medicare’s pay-for-performance program

 

AMI

HF

Pneumonia

High Medicare share hospitals

−0.120* (0.13)

− 0.142 (0.10)

−0.249* (0.13)

Post-HVBP

−2.052* (0.11)

0.484* (0.09)

−0.083 (0.11)

High Medicare share hospitals x Post-HVBP

0.033 (0.11)

−0.054 (0.08)

0.063 (0.10)

Teaching hospital

−0.143 (0.12)

−0.083 (0.11)

0.027 (0.12)

Government non-federal (ref: not-for-profit)

0.358* (0.10)

0.099 (0.08)

0.518* (0.12)

For-profit (ref: not-for-profit)

0.252* (0.08)

−0.200* (0.08)

0.130 (0.10)

Bed size: 100–199 (ref: < 100)

0.299* (0.12)

0.081 (0.08)

−0.127 (0.11)

Bed size: > = 200 (ref: < 100)

0.299* (0.12)

−0.073 (0.09)

− 0.018 (0.12)

Midwest (ref: Northeast)

0.061 (0.09)

0.230* (0.09)

0.016 (0.10)

South (ref: Northeast)

0.442* (0.11)

0.520* (0.10)

0.471* (0.12)

West (ref: Northeast)

0.053 (0.10)

0.544* (0.10)

0.245* (0.12)

DSH %

0.861* (0.22)

−0.551* (0.17)

−0.132 (0.20)

Average daily census

−0.002* (0.0003)

− 0.002* (0.0003)

− 0.002* (0.0003)

Poverty rate

0.010 (0.018)

0.005 (0.02)

−0.006 (0.02)

Unemployment rate

0.007 (0.023)

−0.035 (0.02)

−0.008 (0.02)

N

11,600

14,960

15,048

  1. Sources: Authors’ analysis of Hospital Compare (2009–2016), American Hospital Association Annual Survey (2009), and Final Impact Rules (2009–2016) data
  2. High Medicare share hospitals: Hospitals with Medicare share inpatient days > = 60%; Low Medicare share hospitals: Hospitals with Medicare share inpatient days < 60%
  3. Post-HVBP refers to the period 2011–2016
  4. Estimates from random effects model reported; heteroscedasticity-robust standard errors clustered at the hospital level; model includes year dummies
  5. The difference-in-differences estimates are indicated in bold
  6. Standard errors in parenthesis
  7. *p < 0.05