4033.0: Tuesday, October 23, 2001 - Board 3

Abstract #26533

In-hospital mortality for Medicare beneficiaries: Trends, differentials, and risk factors

Frank F Song, PhD, Virginia Health Quality Center, 1604 Santa Rosa Road, Suite 200, Richmond, VA 23288, 804-289-5320, vapro.fsong@sdps.org

Objective: to examine the risk factors related to in-hospital mortality for Medicare patients.

Risk factors such as racial difference in use of preventive care service by Medicare patients was well-documented, which helped HCFA quality improvement projects to target intervention and education to reduce the disparity in use of preventive care among different race groups. However few research found on quality of inpatient care such as in-hospital mortality at state level? What is the trend of in-hospital mortality in the state? Is there any variation among providers, regions and peer groups? What risk factors are the determinants of the variation of in-hospital mortality rate among providers? Are race and other institutional characteristics of providers also predictors of in-hospital mortality?

The in-hospital mortality rate is a function of many risk factors, which include patient clinical conditions, history of disease, age, admission type, procedures and even geographical locations. Findings on these risk factors may identify potential area for intervention to improve quality of care and to reduce in-hospital mortality for Medicare patients.

Data used was Virginia Medicare beneficiary’s claim data for the period from 1997-1999. Bivariate and multivariate analysis (logistic model) was used to examine these risk factors. Variables used includes demographic, geographic, organizational (CMI, bed-size), clinical factors. Findings and its implications to improve quality of care of elderly will be discussed.

Learning Objectives: To understand the demographic, organizational, geographic, and clinical risk factors realted to in-hospital mortality for Medicare patients and to apply these findings in quality improvement projects for health care.

Keywords: Medicare, Mortality

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA