Abstract
Climate is a known modulator of disease, but its impact on hospital performance metrics remains unstudied. We assess the relationship between Köppen-Geiger climate classification and hospital performance metrics, specifically 30-day mortality, as reported in Hospital Compare, and collected for the period July 2013 through June 2014 (7/1/2013–06/30/2014). A hospital-level multivariate linear regression analysis was performed while controlling for known socioeconomic factors to explore the relationship between all-cause mortality and climate. Hospital performance scores were obtained from 4,524 hospitals belonging to 15 distinct Köppen-Geiger climates and 2,373 unique counties. Model results revealed that hospital performance metrics for mortality showed significant climate dependence (p < 0.001) after adjusting for socioeconomic factors. Climate is a significant factor in evaluating hospital 30-day mortality rates. These results demonstrate that climate classification is an important factor when comparing hospital performance across the United States.
Highlights
Hospital performance statistics are often reported while ignoring regional climate information
The six socioeconomic confounder variables varied across climates (Table S4) and the counties in the United States of America (USA) (Figure S2)
Each confounder was significant across different climates, which motivated us to adjust for these socioeconomic confounders in our model
Summary
Hospital performance statistics are often reported while ignoring regional climate information. Location is usually only mentioned as a confounding factor in determining the fiscal cost of services[12] while ignoring the quality of the result (i.e., the 30-day mortality rate). We selected the Köppen-Geiger climate classification system[13, 14] as a proxy for a high number of intertwined climate variables. Climate classification is an important variable when studying health-related effects as climate determines many facets of season. We selected the Köppen-Geiger climate classification system, which models various facets of climate that affect season intensities. Hospital performance statistics and 30-day mortality rates for many hospitals across the United States of America (USA) are readily available in the Hospital Compare dataset. Hospital Compare is maintained by the Centers for Medicare and Medicaid Services (CMS) with the purpose of providing the general public with information to make informed decisions on their healthcare (www.hospitalcompare.hhs.gov)
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