title: Comparing high- and low-performing hospitals using risk-adjusted excess mortality and cost inefficiency.
abstract: This study examines characteristics associated with high- and low-performing hospitals, where performance is defined in terms of both mortality outcomes and efficiency. In particular, we use data for Florida hospitals in 1999-2001 to classify hospitals into performance groups based on both risk-adjusted excess mortality and cost efficiency. The results indicate that hospitals in the high-performing group were more likely to be for-profit, had higher occupancy rates, had proportionately more Medicare and proportionately fewer Medicaid and self-pay patients, used fewer patient-care personnel per admission, and had higher operating margins than all other hospitals. Hospitals in the low-performing group, on the other hand, were less likely to be for-profit, had more beds, used more patient-care personnel per admission, had lower pay per patient-care personnel, had higher average costs, and had lower operating margins than all other hospitals. Interestingly, managed care presence, measured by proportion of HMO-PPO admissions, was not a significant factor in differentiating hospital performance groups.
authors.affiliation: Department of Health Services Research, Management and Policy, University of Florida, USA. nmckay@phhp.ufl.edu
authors.forename: Niccie L
authors.initials: NL
authors.lastname: McKay
authors.forename: Mary E
authors.initials: ME
authors.lastname: Deily
mesh_terms: D003362:Cost-Benefit Analysis / Q000639:trends*; D017598:Efficiency, Organizational / Q000191:economics* / Q000639:trends; D005431:Florida / Q000453:epidemiology; D006739:Hospital Administration; D017052:Hospital Mortality / Q000639:trends*; D010343:Patient Admission / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms / Q000706:statistics & numerical data; D020379:Risk Adjustment / Q000379:methods*