Medical centre characteristics
| Centre A (n=118) mean (SD), N (%) | Centre B (n=96) mean (SD), N (%) | p Value | |
|---|---|---|---|
| Participant characteristics | |||
| Age | 31.4 (4.6) | 32.2 (5.4) | 0.251 |
| Male | 55 (46.6) | 49 (50.5) | 0.569 |
| Long-term career plans (residents) | |||
| Primary care | 16 (20.3) | 20 (32.3) | 0.107 |
| Hospitalist | 40 (50.6) | 18 (29.0) | 0.010 |
| Subspecialist | 47 (59.5) | 39 (62.9) | 0.680 |
| Years practising Internal Medicine (hospitalists) | 8.4 (3.9) | 10.6 (6.5) | 0.076 |
| Payment (hospitalists) | |||
| Salaried only | 16 (41.0) | 34 (100.0) | 0.001 |
| Combined salary+productivity adjustment | 23 (59.0) | 0 (0.0) | 0.001 |
| Hospital characteristics | |||
| VBP Total Performance Score (national mean 41.7, SD 12.5) | 37.8 | 41.4 | – |
| HCAHPS Score* (National mean 10.7, SD 5.2)† | 7.8 | 13.8 | – |
| Processes of Care Score (national mean 11.1, SD 3.3)† | 13.6 | 8.2 | – |
| Patient Outcome Score (national mean 14.3, SD 6.2)† | 14.4 | 17.4 | – |
| Medicare Payment per Beneficiary Score (efficiency) (national mean 2.9, SD 4.3)† | 2.0 | 2.0 | – |
| Case Mix Index‡ (national mean 1.8, SD 0.3) | 2.4 | 2.2 | – |
| Disproportionate Share Index§ (national mean 0.4, SD 0.2) | 0.3 | 0.5 | – |
| Average daily census (national mean 380.2, SD 244.0) | 433 | 485 | – |
*HCAHPS stands for Hospital Consumer Assessment of Healthcare Providers and Systems.
†Scores postadjusted by standard CMS calculations for fiscal year 2014. Having a higher score denotes higher value performance; therefore Centre B had higher overall value performance for the HCAHPS and Patient Outcome Scores.39
‡Case Mix Index is a measure of the relative cost or resources needed to treat the mix of patients in each licensed hospital during the calendar year, which CMS calculates by summing the diagnosis-related group (DRG) weights for all medicare discharges and dividing by the number of discharges.
§Disproportionate Share Index is an adjustment initially created by CMS to partially compensate hospitals that treat indigent patients. Hospitals whose Disproportionate Share Hospital (DSH) Index exceeds 15% were eligible for a DSH payment adjustment based on another statutory formula that varies based on urban rural status and bed size.
CMS, Center for Medicare and Medicaid Services; VBP, Value-based Purchasing.
Bold text indicates statistical significance at p Value < 0.05.