Specialty hospitals do not have an advantage over general hospitals in mortality rates after cardiac revascularization, even after adjusting for simultaneous relationships between volume and mortality.
Observational
Yes
Does treatment at specialty hospitals reduce mortality rates in patients undergoing cardiac revascularization compared to general hospitals?
Adjusting for simultaneous relationships between volume and mortality confirms that specialty hospitals do not offer a mortality advantage over general hospitals for cardiac revascularization.
Specialty hospitals have lower mortality rates for cardiac revascularization than general hospitals, but previous studies have found that this advantage disappears after adjusting for patient characteristics and hospital procedural volume. Questions have been raised about whether simultaneous relationships between volume and mortality might have biased these analyses. We use two-stage least squares with Hospital Quality Alliance scores and estimated market size as instruments for mortality and volume to control for possible simultaneity. After this adjustment, it is still the case that specialty hospitals do not have an advantage over general hospitals in mortality rates after cardiac revascularization. We find evidence of simultaneity in the relationship between volume and mortality.
Barker et al. (Mon,) conducted a observational in Cardiac revascularization. Specialty hospitals vs. General hospitals was evaluated on Mortality rates after cardiac revascularization. Specialty hospitals do not have an advantage over general hospitals in mortality rates after cardiac revascularization, even after adjusting for simultaneous relationships between volume and mortality.