Table 3.

Association between rurality of patient residence and any use of palliative care or hospice.

Patient Residence	Any palliative care use				Any hospice use
	Unadjusted		Adjusted		Unadjusted		Adjusted
	OR (95% CI)	p	OR (95% CI)	p	OR (95% CI)	p	OR (95% CI)	p
Metropolitan	1.00 (ref)	-	1.00 (ref)	-	1.00 (ref)	-	1.00 (ref)	-
Micropolitan	0.88 (0.81 – 0.95)	0.001	0.93 (0.86 – 1.01)	0.09	1.00 (0.92 – 1.09)	0.943	0.93 (0.85 – 1.02)	0.106
Small Town	0.89 (0.81 – 0.98)	0.02	0.98 (0.88 – 1.08)	0.638	0.84 (0.76 – 0.93)	0.001	0.77 (0.69 – 0.86)	<0.001
Rural	0.95 (0.84 – 1.06)	0.338	1.01 (0.90 – 1.14)	0.807	0.83 (0.73 – 0.94)	0.002	0.75 (0.66 – 0.85)	<0.001

OR= odds ratio; CI= confidence interval

Adjusted models included the following covariates: age, sex, race/ethnicity, Medicare/Medicaid full dual eligibility, disease stage (metastatic vs. not), diabetes, previous myocardial infarction, congestive heart failure, stroke or transient ischemic attack, chronic obstructive pulmonary disorder, end-stage renal disease, the composite CMS-Hierarchical Condition Categories risk adjustment score, and ADI.