Why the study?
Does reduced hospital service line profitability increase 30-day mortality in Medicare patients?
Population
All Medicare discharges from PPS-eligible hospitals in 1997, 2001, and 2005 across 21 hospital service lines
Comparison
Reduced reimbursement/profitability of hospital… vs Higher profitability/baseline reimbursement
Design
Cohort
Follow-up
30-day
Key result
A $0.19 average reduction in profit per $1.00 of costs led to a 0.010-0.020 percentage-point increase in 30-day mortality rates among Medicare discharges (p < .001).
Authors
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May warrant scrutiny of service line profitability to safeguard Medicare outcomes; leaves open whether reimbursement changes causally affect mortality.
Observational
Yes
Does reduced hospital service line profitability increase 30-day mortality in Medicare patients?
Effect estimate: 0.010-0.020 percentage-point increase
p-value: p=<.001
Reduced Medicare reimbursement and hospital service line profitability are associated with small but statistically significant increases in 30-day mortality.
Lindrooth et al. (2013) conducted an observational in Medicare discharges. Reduced service line profitability vs. Service lines that remain profitable was evaluated on Risk-adjusted 30-day mortality (0.010-0.020 percentage-point increase, p=<.001). A $0.19 average reduction in profit per $1.00 of costs led to a 0.010-0.020 percentage-point increase in 30-day mortality rates among Medicare discharges (p < .001).