Empirical Evaluation Results Tables

Sheryl M Davies; Jeffrey Geppert; Mark McClellan; Kathryn M McDonald; Patrick S Romano; Kaveh G Shojania

APPENDIX 7Empirical Evaluation Results Tables

This appendix summarizes the empirical results for each indicator in table format. Indicators are in order according to their unique identifier.

Publication Details

Copyright

Publisher

Agency for Healthcare Research and Quality (US), Rockville (MD)

NLM Citation

Davies SM, Geppert J, McClellan M, et al. Refinement of the HCUP Quality Indicators. Rockville (MD): Agency for Healthcare Research and Quality (US); 2001 May. (Technical Reviews, No. 4.) APPENDIX 7, Empirical Evaluation Results Tables.

Indicator 1: AAA repair volume
Type: Volume
Definition: Provider level. Number of AAA Procedures Threshold 1: 10/yr, Threshold 2: 32/yr
Procedure volume:		Number of procedures performed per year
Procedure volume:	# Hosp with >=1 procedures/yr	Mean	Standard deviation	50^th percentile	90^th percentile	95^th percentile
1995	716	14	16	8	35	47
1996	727	14	16	8	36	46
1997	717	14	16	8	34	52

Procedure share:	Share of procedures done at high volume hospitals		Share of hospitals at high volume
Procedure share:	Threshold 1	Threshold 2	Threshold 1	Threshold 2
1995	84.19%	43.11%	46.09%	12.57%
1996	83.87%	42.99%	44.43%	12.24%
1997	84.70%	41.73%	46.44%	11.58%

Persistence of high volume:	Share of high volume hospitals remaining high volume
Persistence of high volume:	Threshold 1	Threshold 2
1995-1996	86.24%	81.11%
1996-1997	87.03%	75.86%

Indicator 2: Carotid endarterectomy volume
Type: Volume
Definition: Provider level. Number of Carotid Endarterectomy Procedures Threshold 1: 50/yr, Threshold 2: 101/yr
Procedure volume:		Number of procedures performed per year
Procedure volume:	# Hosp with >=1 procedures/yr	Mean	Standard deviation	50^th percentile	90^th percentile	95^th percentile
1995	893	52	60	32	127	158
1996	904	52	60	31.5	129	169
1997	884	54	64	32	133	175

Procedure share:	Share of procedures done at high volume hospitals		Share of hospitals at high volume
Procedure share:	Threshold 1	Threshold 2	Threshold 1	Threshold 2
1995	76.08%	50.32%	35.05%	16.35%
1996	77.77%	51.03%	36.61%	16.70%
1997	78.71%	52.54%	37.33%	17.08%

Persistence of high volume:	Share of high volume hospitals remaining high volume
Persistence of high volume:	Threshold 1	Threshold 2
1995-1996	93.53%	87.50%
1996-1997	89.72%	87.76%

Indicator 3: CABG volume
Type: Volume
Definition: Provider level. Number of CABG Procedures Threshold 1: 100/yr, Threshold 2: 200/yr
Procedure volume:		Number of procedures performed per year
Procedure volume:	# Hosp with >=1 procedures/yr	Mean	Standard deviation	50^th percentile	90^th percentile	95^th percentile
1995	304	375	323	280	804	998
1996	307	399	338	293	830	1095
1997	307	401	345	301	892	1074

Procedure share:	Share of procedures done at high volume hospitals		Share of hospitals at high volume
Procedure share:	Threshold 1	Threshold 2	Threshold 1	Threshold 2
1995	98.03%	89.50%	86.18%	65.13%
1996	98.28%	90.65%	87.62%	67.75%
1997	98.30%	90.71%	87.95%	68.08%

Persistence of high volume:	Share of high volume hospitals remaining high volume
Persistence of high volume:	Threshold 1	Threshold 2
1995-1996	98.85%	96.94%
1996-1997	98.08%	97.49%

Indicator 4: Esophageal resection volume
Type: Volume
Definition: Provider level. Number of Esophageal Resection Procedures Threshold 1: 6/yr, Threshold 2: 7/yr
Procedure volume:		Number of procedures performed per year
Procedure volume:	# Hosp with >=1 procedures/yr	Mean	Standard deviation	50^th percentile	90^th percentile	95^th percentile
1995	265	2	3	1	4	7
1996	265	2	3	1	4	6
1997	233	2	3	1	5	8

Procedure share:	Share of procedures done at high volume hospitals		Share of hospitals at high volume
Procedure share:	Threshold 1	Threshold 2	Threshold 1	Threshold 2
1995	30.43%	26.26%	6.79%	5.28%
1996	39.51%	34.26%	8.58%	6.43%
1997	30.85%	24.47%	5.15%	3.43%

Persistence of high volume:	Share of high volume hospitals remaining high volume
Persistence of high volume:	Threshold 1	Threshold 2
1995-1996	50.00%	57.14%
1996-1997	58.33%	60.00%

Indicator 5: Pancreatic resection volume
Type: Volume
Definition: Provider level. Number of Pancreatic Resection Procedures Threshold 1: 10/yr, Threshold 2: 11/yr
Procedure volume:		Number of procedures performed per year
Procedure volume:	# Hosp with >=1 procedures/yr	Mean	Standard deviation	50^th percentile	90^th percentile	95^th percentile
1995	461	3	5	2	5	8
1996	429	3	4	2	5	10
1997	453	3	5	2	6	8

Procedure share:	Share of procedures done at high volume hospitals		Share of hospitals at high volume
Procedure share:	Threshold 1	Threshold 2	Threshold 1	Threshold 2
1995	30.22%	27.96%	4.77%	4.12%
1996	30.25%	27.03%	5.13%	4.19%
1997	31.58%	31.58%	4.41%	4.41%

Persistence of high volume:	Share of high volume hospitals remaining high volume
Persistence of high volume:	Threshold 1	Threshold 2
1995-1996	72.73%	73.68%
1996-1997	71.43%	82.35%

Indicator 6: Pediatric heart surgery volume
Type: Volume
Definition: Provider level. Number of Pediatric Heart Surgery Procedures Threshold 1: 100/yr, Threshold 2: 100/yr
Procedure volume:		Number of procedures performed per year
Procedure volume:	# Hosp with >=1 procedures/yr	Mean	Standard deviation	50^th percentile	90^th percentile	95^th percentile
1995	135	52	86	2	145	244
1996	126	53	90	2.5	149	245
1997	126	52	91	2	143	263

Procedure share:	Share of procedures done at high volume hospitals		Share of hospitals at high volume
Procedure share:	Threshold 1	Threshold 2	Threshold 1	Threshold 2
1995		72.88%		19.26%
1996		75.52%		20.63%
1997		74.33%		19.05%

Persistence of high volume:	Share of high volume hospitals remaining high volume
Persistence of high volume:	Threshold 1	Threshold 2
1995-1996		84.62%
1996-1997		84.00%

Indicator 7: PTCA volume
Type: Volume
Definition: Provider level. Number of PTCA Procedures Threshold 1: 200/yr, Threshold 2: 400/yr
Procedure volume:		Number of procedures performed per year
Procedure volume:	# Hosp with >=1 procedures/yr	Mean	Standard deviation	50^th percentile	90^th percentile	95^th percentile
1995	354	379	367	292	803	1066
1996	356	418	400	330	869	1157
1997	354	447	428	338	934	1290

Procedure share:	Share of procedures done at high volume hospitals		Share of hospitals at high volume
Procedure share:	Threshold 1	Threshold 2	Threshold 1	Threshold 2
1995	94.41%	72.54%	65.82%	37.29%
1996	95.70%	77.01%	68.82%	42.13%
1997	95.38%	79.06%	69.21%	44.63%

Persistence of high volume:	Share of high volume hospitals remaining high volume
Persistence of high volume:	Threshold 1	Threshold 2
1995-1996	97.84%	98.47%
1996-1997	97.88%	96.53%

Indicator 8: Cesarean section delivery rate
Type: Provider level utilization
Definition: Provider level. Number of cesarean section delivery per 100 deliveries.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.214	0.087	0.045	0.012	0.880	0.922
Demographics	-	-	0.045	0.012	0.882	0.925

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.956	0.054	0.724	0.793	0.026

Indicator 9: Incidental appendectomy among elderly rate
Type: Provider level utilization
Definition: Provider level. Number of incidental appendectomies per 100 patients age 65 years or older undergoing intra-abdominal surgery.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.027	0.035	0.019	0.015	0.554	0.670
Demographics	-	-	0.019	0.018	0.590	0.689
APR-DRG	-	-	0.019	0.014	0.554	0.673

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.988	0.050	0.829	0.946	0.003

Indicator 10: Bi-lateral cardiac catheterization rate
Type: Provider level utilization
Definition: Provider level. Number of bilateral cardiac catheterizations per 100 heart catheterizations.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.193	0.200	0.163	0.147	0.944	0.963
Demographics	-	-	0.162	0.140	0.942	0.961
APR-DRG	-	-	0.161	0.144	0.943	0.962

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.988	0.061	0.707	0.966	0.002

Indicator 11: Successful vaginal birth after cesarean section (VBAC) rate
Type: Provider level utilization
Definition: Provider level. Number of successful vaginal deliveries per 100 deliveries in women with previous cesarean section.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.336	0.148	0.115	0.055	0.825	0.889
Demographics	-	-	0.117	0.057	0.831	0.895

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.995	0.031	0.931	0.943	0.000

Indicator 12: Laparoscopic cholecystectomy rate
Type: Provider level utilization
Definition: Provider level. Number of laparoscopic cholecystectomies per 100 cholecystectomies (open and laparoscopic) performed.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.662	0.192	0.137	0.083	0.836	0.893
Demographics	-	-	0.133	0.079	0.831	0.891

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.966	0.039	0.938	0.788	0.025

Indicator 13: Coronary artery bypass graft (CABG) rate
Type: Area level utilization
Definition: Area level. Number of CABGs per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.001804	0.005716	0.002508	0.002152	0.973	0.974
Demographics	-	-	0.002486	0.002117	0.973	0.973

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.6548	0.126	0.364	0.955	0.350

Indicator 14: Hysterectomy rate
Type: Area level utilization
Definition: Area level. Number of hysterectomies per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.004194	0.003233	0.001840	0.000940	0.933	0.935
Demographics	-	-	0.001881	0.000983	0.936	0.937

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9964	0.030	0.818	0.909	0.000

Indicator 15: Laminectomy and/or spinal fusion rate
Type: Area level utilization
Definition: Area level. Number of laminectomies per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.001390	0.003475	0.001328	0.001020	0.967	0.967
Demographics	-	-	0.001320	0.001009	0.967	0.967

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9333	0.063	0.318	0.955	0.074

Indicator 16: Percutaneous transluminal coronary angioplasty (PTCA) rate
Type: Area level utilization
Definition: Area level. Number of PTCAs per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.001908	0.004556	0.002780	0.002163	0.973	0.974
Demographics	-	-	0.002750	0.002120	0.973	0.973

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.6712	0.104	0.364	0.955	0.355

Indicator 17: Dehydration admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for dehydration per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.001399	0.001032	0.000484	0.000216	0.900	0.903
Demographics	-	-	0.000446	0.000184	0.885	0.889

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9572	0.092	0.818	0.909	0.046

Indicator 18: Bacterial pneumonia admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for bacterial pneumonia per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.003956	0.002085	0.000971	0.000343	0.932	0.933
Demographics	-	-	0.000948	0.000326	0.929	0.931

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9234	0.111	0.682	0.909	0.097

Indicator 19: Urinary infection admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for urinary infection per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.001451	0.000895	0.000395	0.000134	0.854	0.859
Demographics	-	-	0.000386	0.000128	0.849	0.854

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9143	0.115	0.682	0.909	0.088

Indicator 20: Perforated appendix admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for perforated appendix per 100 admissions for appendicitis within an area.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.332740	0.144097	0.032117	0.004604	0.308	0.436
Demographics	-	-	0.027529	0.003387	0.265	0.394

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9687	0.020	0.900	0.850	0.025

Indicator 21: Angina (without procedure) admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for angina (without procedure) per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.001660	0.001357	0.000639	0.000392	0.921	0.923
Demographics	-	-	0.000614	0.000362	0.916	0.919

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9677	0.106	0.636	0.909	0.032

Indicator 22: Adult asthma admission rate.
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for adult asthma per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.001079	0.000817	0.000443	0.000158	0.840	0.846
Demographics	-	-	0.000435	0.000153	0.836	0.842

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9879	0.038	0.864	0.955	0.000

Indicator 23: Chronic obstructive pulmonary disease (COPD) admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for COPD per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.003240	0.002038	0.001153	0.000646	0.950	0.950
Demographics	-	-	0.000986	0.000472	0.934	0.935

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9333	0.135	0.682	0.864	0.069

Indicator 24: Congestive heart failure admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for CHF per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.005210	0.002865	0.001772	0.000708	0.954	0.954
Demographics	-	-	0.001404	0.000444	0.930	0.932

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.8577	0.196	0.545	0.818	0.166

Indicator 25: Diabetes - short term complications admissions rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for diabetes short term complications (uncontrolled diabetes, DKA, hyperosmolarity, and coma) per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.000360	0.000246	0.000092	0.000022	0.518	0.543
Demographics	-	-	0.000092	0.000022	0.517	0.543

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9951	0.006	1.000	1.000	0.005

Indicator 26: Uncontrolled diabetes
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for uncontrolled diabetes per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.000347	0.000281	0.000152	0.000078	0.735	0.751
Demographics	-	-	0.000147	0.000074	0.726	0.742

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9764	0.079	0.773	0.909	0.023

Indicator 27: Diabetes - long-term complications admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for diabetes long-term complications (neurological, circulatory, eye, kidney, NOS), per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.000808	0.000581	0.000265	0.000077	0.741	0.752
Demographics	-	-	0.000279	0.000085	0.756	0.766

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9264	0.124	0.727	0.909	0.083

Indicator 28: Hypertension admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for hypertension per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.000371	0.000322	0.000142	0.000066	0.716	0.728
Demographics	-	-	0.000138	0.000060	0.699	0.712

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9631	0.091	0.727	1.000	0.032

Indicator 29: Lower extremity amputation in diabetics admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for lower extremity amputation and diagnosis code for diabetes per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.000305	0.000427	0.000146	0.000064	0.706	0.722
Demographics	-	-	0.000137	0.000057	0.685	0.702

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9192	0.131	0.591	0.909	0.074

Indicator 30: Low birth weight rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of infants with a birth weight of under 2500 grams per 100 births within area.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.039108	0.023135	0.011832	0.002720	0.671	0.812
Demographics	-	-	0.011836	0.002722	0.671	0.812

Minimum bias:	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	NA	NA	NA	NA	NA

Indicator 31: Pediatric asthma admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for asthma in patients age 18 years and younger per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.001541	0.001439	0.001137	0.000514	0.853	0.858
Demographics	-	-	0.001129	0.000506	0.851	0.856

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9938	0.053	1.000	0.955	0.000

Indicator 32: Pediatric gastroenteritis admission rate
Type: Avoidable hospitalization/ Ambulatory Care Sensitive Condition (ACSC)
Definition: Area level. Number of admissions for gastroenteritis in patients age 18 years and younger per 100,000 population.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.000985	0.001012	0.000535	0.000291	0.778	0.788
Demographics	-	-	0.000537	0.000293	0.778	0.788

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.9953	0.055	0.909	1.000	0.000

Indicator 33: Acute myocardial infarction (AMI) mortality rate
Type: In-patient mortality
Definition: Provider level. Number of deaths per 100 patients with diagnosis of AMI.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.244	0.161	0.078	0.043	0.718	0.826
Demographics	-	-	0.061	0.023	0.617	0.756
APR-DRG	-	-	0.034	0.008	0.428	0.590

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.747	0.324	0.363	0.673	0.290

Indicator 34: Congestive heart failure (CHF) mortality rate
Type: In-patient mortality
Definition: Provider level. Number of deaths per 100 patients with diagnosis of CHF.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.075	0.095	0.025	0.010	0.598	0.750
Demographics	-	-	0.021	0.007	0.505	0.696
APR-DRG	-	-	0.021	0.007	0.535	0.697

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.794	0.137	0.398	0.729	0.235

Indicator 35: Gastrointestinal (GI) hemorrhage mortality rate
Type: In-patient mortality
Definition: Provider level. Number of deaths per 100 patients with diagnosis of GI hemorrhage.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.046	0.057	0.016	0.006	0.323	0.589
Demographics	-	-	0.013	0.003	0.224	0.607
APR-DRG	-	-	0.011	0.003	0.202	0.555

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.803	0.105	0.504	0.678	0.229

Indicator 36: Hip fracture mortality rate
Type: In-patient mortality
Definition: Provider level. Number of deaths per 100 patients with diagnosis of hip fracture.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.144	0.160	0.079	0.062	0.544	0.670
Demographics	-	-	0.072	0.048	0.476	0.635
APR-DRG	-	-	0.078	0.060	0.543	0.653

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.880	0.225	0.556	0.788	0.151

Indicator 37: Pneumonia mortality rate
Type: In-patient mortality
Definition: Provider level. Number of deaths per 100 patients with diagnosis of pneumonia.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.138	0.102	0.052	0.022	0.744	0.850
Demographics	-	-	0.045	0.015	0.675	0.822
APR-DRG	-	-	0.037	0.012	0.629	0.781

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.596	0.219	0.306	0.603	0.408

Indicator 38: Acute stroke mortality rate
Type: In-patient mortality
Definition: Provider level. Number of deaths per 100 patients with diagnosis of stroke (not TIA).
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.213	0.137	0.070	0.029	0.626	0.756
Demographics	-	-	0.067	0.025	0.589	0.738
APR-DRG	-	-	0.053	0.017	0.519	0.707

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.803	0.131	0.638	0.629	0.244

Indicator 39: Abdominal aortic aneurysm repair mortality rate
Type: Post-procedural mortality
Definition: Provider level. Number of deaths per 100 patients having undergone AAA repair.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.215	0.268	0.085	0.060	0.423	0.540
Demographics	-	-	0.067	0.035	0.037	0.571
APR-DRG	-	-	NA	NA	NA	NA

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.890	0.234	0.708	0.646	0.141

Indicator 40: Coronary artery bypass graft (CABG) mortality rate
Type: Post-procedural mortality
Definition: Provider level. Number of deaths per 100 patients having undergone CABG.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.051	0.062	0.017	0.007	0.611	0.726
Demographics	-	-	0.016	0.006	0.552	0.727
APR-DRG	-	-	0.014	0.005	0.545	0.698

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.743	0.152	0.414	0.655	0.301

Indicator 41: Craniotomy mortality rate
Type: Post-procedural mortality
Definition: Provider level. Number of deaths per 100 patients having undergone craniotomy.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.162	0.185	0.084	0.071	0.589	0.719
Demographics	-	-	0.077	0.054	0.527	0.704
APR-DRG	-	-	0.037	0.015	0.289	0.490

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.786	0.338	0.296	0.611	0.274

Indicator 42: Esophageal resection mortality rate
Type: Post-procedural mortality
Definition: Provider level. Number of deaths per 100 patients having undergone esophageal resection for cancer.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.202	0.366	0.043	0.026	0.120	0.353
Demographics	-	-	0.024	0.008	0.089	0.210
APR-DRG	-	-	NA	NA	NA	NA

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.858	0.168	0.667	1.000	0.095

Indicator 43: Hip replacement mortality rate
Type: Post-procedural mortality
Definition: Provider level. Number of deaths per 100 patients having undergone total or partial hip arthroplasty.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.012	0.057	0.013	0.029	0.339	0.346
Demographics	-	-	0.012	0.021	0.202	0.218
APR-DRG	-	-	0.009	0.012	0.200	0.216

Minimum bias:	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.642	0.489	0.278	0.708	0.361

Indicator 44: Pancreatic resection mortality rate
Type: Post-procedural mortality
Definition: Provider level. Number of deaths per 100 patients having undergone pancreatic resection for cancer.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.154	0.313	0.079	0.084	0.315	0.359
Demographics	-	-	0.042	0.032	0.165	0.347
APR-DRG	-	-	NA	NA	NA	NA

Minimum bias (age-sex):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.540	0.419	0.714	0.286	0.381

Indicator 45: Pediatric heart surgery mortality rate
Type: Post-procedural mortality
Definition: Provider level. Number of deaths per 100 patients age 18 and under having undergone heart surgery.
Precision:	Provider Level		Provider Signal
	Mean	Std Dev	Std Dev (1)	Share (2)	Univariate Ratio (3)	MSX R² (4)
Unadjusted	0.072	0.170	0.022	0.008	0.357	0.496
Demographics	-	-	0.017	0.005	0.263	0.430
APR-DRG	-	-	0.015	0.003	0.222	0.379

Minimum bias (APR-DRG):	Rank Corr. (1)	Absolute Diff (2)	High 10% (3)	Low 10% (4)	Two Decile Diff (5)
MSX	0.674	0.128	0.167	0.667	0.351