State experience with Medicare hospital mortality: how does New York State compare?

1987 Medicare hospital mortality statistics for 255 New York hospitals (including 57 hospitals in New York City) were compared with 4,617 hospitals located in other states. An analysis of covariance examined how overall Medicare hospital mortality rates differed across states; these rates were adjusted for expected mortality, hospital bed size, and major teaching status. This study tested for the hypothesis that New York State had an average 30-day post-admission Medicare mortality rate significantly different from the mean hospital mortality rate for all states. The results indicated that New York State was -0.43 percentage points below the average risk-adjusted mortality rate of the other states (p < 0.0001). Although it remains speculative to what extent differences in adjusted Medicare hospital mortality are a function of quality of care, these results indicate that New York's historically high level of hospital regulation has not resulted in inferior patient outcomes.