The Implications of Regional Variations in Medicare Spending. Part 2: Health Outcomes and Satisfaction with Care

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   Figure 1. Circles represent adjusted relative risk for death among residents of hospital referral regions in the specified quintile of the End-of-Life Expenditure Index (EOL-EI) compared to the risk for death among residents of hospital referral regions in quintile 1 of the EOL-EI; bars represent 95% CIs. MCBS = Medicare Current Beneficiary Survey; MI = myocardial infarction; Q1 = quintile 1; Q2 = quintile 2; Q3 = quintile 3; Q4 = quintile 4; Q5 = quintile 5. Adjusted relative risk for death during follow-up across quintiles of Medicare spending.
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   Figure 2. Income figures refer to the average monthly Social Security income of the patients' ZIP codes. Circles represent the adjusted relative risk for death associated with a 10% increase in the End-of-Life Expenditure Index across U.S. hospital referral regions; bars represent 95% CIs for the relative risk. *Mid-Atlantic, South Atlantic, and Great Lakes regions. †Did not change hospital referral region of residence in the 1 to 2 years before index admission. HMO = health maintenance organization. Adjusted relative risk for death associated with a 10% increase in Medicare spending overall and among specified subgroups of the hip fracture cohort.
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   Figure 3. Income figures refer to the average monthly Social Security incomes of the patients' ZIP code. Circles represent the adjusted relative risk for death associated with a 10% increase in the End-of-Life Expenditure Index across U.S. hospital referral regions; bars represent 95% CIs for the relative risk. *Mid-Atlantic, South Atlantic, and Great Lakes regions. †Did not change hospital referral region of residence in the 1 to 2 years before index admission. HMO = health maintenance organization. Adjusted relative risk for death associated with a 10% increase in Medicare spending overall and among specified subgroups of the colorectal cancer cohort.
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   Figure 4. ) cohort. Income figures refer to the average monthly Social Security income of the patients' ZIP codes. Circles represent the adjusted relative risk for death associated with a 10% increase in the End-of-Life Expenditure Index across U.S. hospital referral regions; bars represent 95% CIs for the relative risk. *Mid-Atlantic, South Atlantic, and Great Lakes regions. †Did not change hospital referral region of residence in the 1 to 2 years before index admission. HMO = health maintenance organization. Adjusted relative risk for death associated with a 10% increase in Medicare spending overall and among specified subgroups of the acute myocardial infarction ( MI
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   Figure 5. An arrow pointing upward indicates a positive association between increased spending and satisfaction. Bars represents 95% CIs. Q1 = quintile 1; Q5 = quintile 5. Satisfaction with care.

• Copyright ©2004 by the American College of Physicians