Patients and Patient Outcomes
Discharge abstracts representing all admissions to nonfederal hospitals in Pennsylvania from 1998 to 1999 were obtained from the Pennsylvania Health Care Cost Containment Council. These discharge abstracts were merged with Pennsylvania vital statistics records to identify patients who died within 30 days of hospital admission to control for timing of discharge as a possible source of variation in hospital outcomes. We examined outcomes for 232 342 patients between the ages of 20 and 85 years who underwent general surgical, orthopedic, or vascular procedures in the 168 hospitals from April 1, 1998, to November 30, 1999. Surgical discharges were selected for study because of the availability of well-validated risk adjustment models.24- 29 The number of patients discharged from the study hospitals ranged from 75 to 7746. Only the first hospital admission for any of the DRGs listed in the BOX for any patient during the study period was included in the analyses.