Author Contributions: Dr Pine had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Pine, Jordan, Elixhauser, Hoaglin.
Acquisition of data: Jordan, Elixhauser, Jones.
Analysis and interpretation of data: Pine, Jordan, Fry, Hoaglin, Jones, Meimban, Warner, Gonzales.
Drafting of the manuscript: Pine, Jordan, Fry, Jones, Meimban, Warner.
Critical revision of the manuscript for important intellectual content: Jordan, Elixhauser, Hoaglin, Gonzales.
Statistical analysis: Pine, Jordan, Hoaglin, Jones, Meimban.
Obtained funding: Pine, Jordan, Elixhauser.
Administrative, technical, or material support: Pine, Jordan, Elixhauser, Warner.
Study supervision: Pine, Jordan, Elixhauser.
Financial Disclosures: Dr Hoaglin reported owning shares of stock in Cardinal Health Inc. None of the other authors reported any disclosures.
Funding/Support: This study was supported by the Agency for Healthcare Research and Quality contract 233-02-0088 (task order 13).
Role of the Sponsor: The Agency for Healthcare Research and Quality (AHRQ) specified the overarching study design in a request for proposal. Data were collected by Pennsylvania hospitals, which were required by law to submit these data to the Pennsylvania Health Care Cost Containment Council. Data were transmitted to the AHRQ by the Council and the AHRQ transmitted them to the authors. Further data management, analyses, interpretation, and preparation of the manuscript were the independent work of the authors. The manuscript was reviewed by the Council and by the director of the Center for Delivery, Organizations, and Markets at AHRQ prior to the initial submission. Complete specifications of data elements, potential risk factors, and risk-adjustment equations are available in the final report submitted to the AHRQ. Administrative and Atlas clinical data were provided by the Council, an independent state agency responsible for addressing the problem of escalating health costs, ensuring the quality of health care, and increasing access to health care for all citizens regardless of ability to pay. The Council provided data in an effort to further its mission of educating the public and containing health care costs in Pennsylvania. The Council, its agents and staff, have made no representation, guarantee, or warranty, express or implied, that the data are error-free, or that the use of the data will avoid differences of opinion or interpretation. Analyses reported in this article were not prepared by the Council.
Disclaimer: The Pennsylvania Health Care Cost Containment Council, its agents and staff, bear no responsibility or liability for the results of these analyses, which are solely the opinion of the authors.