Table 3:
Factors associated with distance bypassed among birthing people who bypass their local hospital (in miles; OLS regression)
| Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |
|---|---|---|---|---|---|
| Lives on Reservation | 9.14* (3.45,14.83) | 9.19* (3.50,14.87) | 10.81* (5.03,16.59) | 8.04* (2.37,13.70) | 9.76* (4.00,15.51) |
| Race (White ref) | |||||
| Black | −1.37 (−21.87,19.13) | −1.37 (−21.87,19.13) | −1.37 (−21.87,19.13) | −1.37 (−21.87,19.13) | −1.37 (−21.87,19.13) |
| AI/AN | 14.93* (8.87,20.99) | 9.834* (3.01,16.66) | 14.00* (7.91,20.08) | −4.26 (−13.09,4.56) | −8.06 (−17.31,1.19) |
| Asian | 0.71 (−14.61,16.04) | 0.67 (−14.64,15.98) | 0.70 (−14.62,16.01) | 0.34 (−14.90,15.58) | 0.31 (−14.92,15.54) |
| Hispanic | −1.53 (−9.96,6.90) | −1.43 (−9.85,7.00) | −1.82 (−10.25,6.60) | −1.31 (−9.70,7.07) | −1.56 (−9.93,6.82) |
| Age (in years) | −0.20 (−0.50,0.10) | −0.23 (−0.53,0.08) | −0.20 (−0.50,0.10) | −0.22 (−0.52,0.08) | −0.24 (−0.54,0.06) |
| Education (college plus ref) | |||||
| Less than High School education | −9.56* (−15.23,−3.89) | −9.74* (−15.41,−4.08) | −9.33* (−14.99,−3.66) | −10.10* (−15.74,−4.46) | −9.94* (−15.58,−4.30) |
| High school | 0.57 (−3.83,4.97) | 0.49 (−3.91,4.89) | 0.68 (−3.72,5.08) | 0.72 (−3.66,5.10) | 0.77 (−3.60,5.15) |
| Some college | 2.17 (−1.79,6.12) | 2.05 (−1.91,6.02) | 2.19 (−1.77,6.14) | 1.67 (−2.26,5.61) | 1.64 (−2.30,5.57) |
| Rurality Urban Continuum Codes (RUCC; RUCC 3 ref) | |||||
| 5 | −51.03* (−67.3,−34.8) | −50.58* (−66.8,−34.4) | −51.65* (−67.9,−35.4) | −53.55* (−69.7,−37.4) | −53.90* (−70.1,−37.7) |
| 6 | −100.10* (−116.5,−86.7) | −99.55* (−116.0,−83.1) | −101.00* (−117.4,−84.6) | −100.40* (−116.8,−84.1) | −101.00* (−117.4,−84.7) |
| 7 | −45.26* (−61.4,−29.1) | −44.66* (−60.8,−28.5) | −46.13* (−62.3,−30.0) | −44.92* (−61.0,−28.9) | −45.49* (−61.6,−29.4) |
| 8 | −73.41* (−89.9,−56.9) | −72.89* (−89.4,−56.4) | −74.11* (−90.6,−57.6) | −73.91* (−90.3,−57.5) | −74.30* (−90.7,−57.9) |
| 9 | −67.36* (−83.8,−50.9) | −66.81* (−83.3,−50.4) | −68.21* (−84.7,−51.8) | −67.90* (−84.3,−51.5) | −68.44* (−84.8,−52.1) |
| Had pregnancy risk factor(s) | 10.57* (7.15,14.00) | 8.67* (5.05,12.29) | 10.56* (7.14,13.98) | 10.42* (7.01,13.83) | 9.31* (5.71,12.91) |
| Birth was preterm | 9.77* (4.10,15.44) | 9.64* (3.98,15.31) | 9.89* (4.22,15.55) | 9.21* (3.57,14.85) | 9.28* (3.64,14.91) |
| Birth was low birth weight | 10.71* (4.74,16.68) | 10.75* (4.78,16.72) | 10.56* (4.59,16.53) | 10.82* (4.88,16.76) | 10.69* (4.75,16.62) |
| Cesarean section | 1.25 (−2.07,4.57) | 1.14 (−2.18,4.46) | 1.11 (−2.20,4.43) | 1.42 (−1.89,4.71) | 1.21 (−2.09,4.51) |
| Attending provider type (Doctor ref) | |||||
| Midwife | 0.52 (−5.60,6.64) | 0.32 (−5.80,6.43) | 0.44 (−5.68,6.55) | 0.17 (−5.92,6.26) | −0.03 (−6.11,6.05) |
| Other provider | −7.79 (−23.52,7.95) | −7.71 (−23.43,8.02) | −7.64 (−23.37,8.08) | −10.55 (−26.22,5.13) | −10.34 (−26.01,5.32) |
| Had a previous live birth | 0.78 (−2.48,4.05) | 0.64 (−2.62,3.90) | 0.70 (−2.56,3.96) | 0.53 (−2.72,3.77) | 0.36 (−2.88,3.61) |
| Birth was to multiples | 15.82* (9.04,22.61) | 16.26* (9.48,23.04) | 15.75* (8.97,22.53) | 15.90* (9.16,22.65) | 16.11* (9.36,22.85) |
| Kotelchuck Prenatal Care index (No prenatal care ref) | |||||
| Inadequate care | −21.82* (−37.5,−6.2) | −22.69* (−38.3,−7.0) | −22.11* (−37.8,−6.5) | −22.13* (−37.7,−6.5) | −22.80* (−38.4,−7.19) |
| Intermediate care | −29.79* (−45.8,−13.8) | −30.81* (−46.9,−14.8) | −30.01* (−46.0,−14.0) | −29.66* (−45.6,−13.7) | −30.35* (−46.4,−14.4) |
| Adequate care | −34.40* (−50.1,−18.7) | −35.45* (−51.1,−19.8) | −34.65* (−50.3,−19.0) | −33.86* (−49.5,−18.2) | −34.62* (−50.2,−19.0) |
| Adequate plus care | −31.85* (−47.5,−16.6) | −32.79* (−48.5,−17.1) | −32.06* (−47.7,−16.4) | −31.31* (−47.0,−15.7) | −31.98* (−47.6,−16.3) |
| Payer (private insurance ref) | |||||
| Self-pay | 9.06* (2.02,16.09) | 8.96* (1.93,15.99) | 9.00* (1.97,16.03) | 9.16* (2.17,16.16) | 9.07* (2.08,16.05) |
| Medicaid | 1.52 (−1.98,5.02) | 1.51 (−1.99,5.01) | 1.34 (−2.16,4.84) | 1.38 (−2.10,4.86) | 1.21 (−2.27,4.69) |
| Military insurance | 0.60 (−15.4,16.6) | 0.20 (−15.8,16.2) | 0.59 (−15.4,16.6) | 0.36 (−15.6,16.3) | 0.13 (−15.8,16.0) |
| Indian Health Services (IHS) | −0.86 (−14.3,12.5) | −0.76 (−14.2,12.6) | 24.4* (3.53,45.2) | −0.58 (−13.9,12.7) | 24.4* (3.72,45.2) |
| OB Level of closest hospital (Level 1 ref) | |||||
| Level 2 | −0.55 (−5.97,4.87) | −0.46 (−5.87,4.96) | −0.72 (−6.14,4.69) | −0.59 (−5.98,4.80) | −0.70 (−6.09,4.68) |
| Level 3 | 34.80* (19.33,50.28) | 35.27* (19.80,50.74) | 34.09* (18.62,49.57) | 34.41* (19.02,49.80) | 33.99* (18.60,49.38) |
| Distance to closest hospital (miles) | −0.12* (−0.22,−0.03) | −0.12* (−0.22,−0.03) | −0.13* (−0.22,−0.03) | −0.14* (−0.23,−0.05) | −0.14* (−0.23,−0.05) |
| OB Level of birth hospital (Level 1 ref) | |||||
| Level 2 | 41.47* (37.1,45.8) | 41.38* (37.1,45.7) | 41.64* (37.3,46.0) | 33.95* (29.2,38.7) | 34.24* (29.5,39.0) |
| Level 3 | 48.46* (44.4,52.5) | 48.58* (44.5,52.7) | 48.58* (44.5,52.7) | 44.33* (39.9,48.8) | 44.49* (40.0,49.0) |
| Interactions | |||||
| AI/AN X Pregnancy Risk | 13.97* (5.4,22.6) | 8.27^ (−0.41,16.95) | |||
| Lives on Reservation X IHS | −42.19* (−68.9,−15.5) | −41.82* (−68.4,−15.2) | |||
| AI/AN X OB Level of birth hospital | |||||
| AI/AN X OB Level 2 | 47.82* (36.4,59.2) | 46.45* (34.9,58.0) | |||
| AI/AN X OB Level 3 | 17.19* (7.4,27.0) | 17.56* (7.7,27.4) | |||
| Constant | 126.70* (102.3,151.2) | 128.60* (104.2,153.0) | 127.90* (103.5,152.3) | 132.80* (108.5,157.1) | 134.90* (110.5,159.2) |
| R2 | 0.257 | 0.258 | 0.258 | 0.265 | 0.267 |
| BIC | 65459.6 | 65458.1 | 65458.6 | 65408.2 | 65412.1 |
Notes: confidence intervals are in parentheses; n = 5,991 births to individuals who were residents of Montana at the time of birth, who bypassed their closest hospital to give birth
*
p < .05
RUCC codes described in measurement section