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Slide Presentation from the AHRQ 2007 Annual Conference

Better PSI Performance Associated CAH Conversion: Alternative Explanations

Changes in coding behaviors
- Did not find any significant change in hospital-level mean number of DX, mean Charlson score, mean number of Elixhauser comorbidities
Changes in referral patterns (get less severe patients)
- No significant change in
  - Percentage of patients transferred from other hospitals
  - Percentage of patients transferred to other hospitals
- Models adjusting for referral behaviors show consistent results
It reflects a trend toward improvement in patient safety for all hospitals
- None-converted hospitals are comparison group
- Add year dummy variables
- Difference in difference