Table 5. Multivariate predictors of readmission with and without heart failure.
| Variables | Multivariate predictors of readmissions with heart failure only(H) | Multivariate predictors of readmissions except for heart failure(NH) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| aOR | 95% CI | p value | aOR | 95% CI | p value | ||||
| LL | UL | LL | UL | ||||||
| Age | 0.981 | 0.978 | 0.984 | <0.001 | 0.991 | 0.989 | 0.994 | <0.001 | |
| Sex | |||||||||
| Female | Referent | Referent | |||||||
| Male | 1.19 | 1.11 | 1.28 | <0.001 | 0.98 | 0.92 | 1.03 | 0.389 | |
| Median household income (percentile)* | |||||||||
| 0–25 | 1.26 | 1.13 | 1.39 | <0.001 | 1.19 | 1.09 | 1.29 | <0.001 | |
| 26–50 | 1.03 | 0.93 | 1.14 | 0.592 | 1.00 | 0.92 | 1.09 | 0.965 | |
| 51–75 | 1.05 | 0.94 | 1.17 | 0.386 | 0.99 | 0.91 | 1.07 | 0.750 | |
| 76–100 | Referent | Referent | |||||||
| Admission type | |||||||||
| Elective | Referent | Referent | |||||||
| Non-elective | 1.16 | 0.99 | 1.37 | 0.067 | 1.10 | 0.97 | 1.25 | 0.124 | |
| Day of admission | |||||||||
| Weekday | Referent | Referent | |||||||
| Weekend | 1.09 | 1.01 | 1.17 | 0.034 | 0.99 | 0.93 | 1.06 | 0.871 | |
| Bed size of hospital† | |||||||||
| Small | Referent | Referent | |||||||
| Medium | 0.99 | 0.90 | 1.09 | 0.811 | 1.00 | 0.93 | 1.09 | 0.915 | |
| Large | 0.98 | 0.90 | 1.06 | 0.581 | 1.01 | 0.94 | 1.08 | 0.741 | |
| Teaching status of hospital‡ | |||||||||
| Non-metropolitan hospital | Referent | Referent | |||||||
| Metropolitan non-teaching | 1.18 | 1.04 | 1.33 | 0.010 | 1.12 | 1.02 | 1.24 | 0.021 | |
| Metropolitan teaching | 1.19 | 1.07 | 1.33 | 0.001 | 1.15 | 1.05 | 1.25 | 0.001 | |
| Expected primary payer | |||||||||
| Medicare | Referent | Referent | |||||||
| Medicaid | 1.31 | 1.18 | 1.46 | <0.001 | 0.92 | 0.83 | 1.01 | 0.075 | |
| Private insurance | 0.62 | 0.55 | 0.70 | <0.001 | 0.77 | 0.70 | 0.84 | <0.001 | |
| Self-pay | 0.76 | 0.62 | 0.92 | 0.006 | 0.62 | 0.52 | 0.74 | <0.001 | |
| No charge | 1.15 | 0.62 | 2.13 | 0.666 | 1.24 | 0.73 | 2.12 | 0.425 | |
| Other | 0.95 | 0.76 | 1.20 | 0.688 | 0.84 | 0.68 | 1.02 | 0.079 | |
| Comorbidities§ | |||||||||
| Hypertension | 0.98 | 0.90 | 1.07 | 0.679 | 1.02 | 0.95 | 1.09 | 0.587 | |
| Diabetes | 1.07 | 0.99 | 1.16 | 0.105 | 1.03 | 0.96 | 1.09 | 0.463 | |
| Dyslipidemia | 1.04 | 0.96 | 1.13 | 0.289 | 0.95 | 0.89 | 1.01 | 0.114 | |
| Atrial fibrillation or flutter | 1.20 | 1.11 | 1.29 | <0.001 | 1.13 | 1.06 | 1.19 | <0.001 | |
| PVD | 0.87 | 0.75 | 1.00 | 0.054 | 1.17 | 1.06 | 1.30 | 0.003 | |
| Prior CAD | 1.09 | 1.01 | 1.17 | 0.037 | 1.01 | 0.95 | 1.08 | 0.698 | |
| Prior TIA/Stroke | 0.96 | 0.86 | 1.09 | 0.551 | 1.01 | 0.92 | 1.11 | 0.882 | |
| Prior CABG | 1.09 | 0.97 | 1.23 | 0.149 | 0.97 | 0.88 | 1.07 | 0.536 | |
| Prior PCI | 1.34 | 0.98 | 1.84 | 0.071 | 0.99 | 0.73 | 1.34 | 0.937 | |
| FH of CAD | 0.97 | 0.85 | 1.11 | 0.693 | 1.01 | 0.90 | 1.13 | 0.889 | |
| COPD | 1.16 | 1.07 | 1.25 | <0.001 | 1.16 | 1.09 | 1.24 | <0.001 | |
| CKD | 1.48 | 1.35 | 1.61 | <0.001 | 1.01 | 0.94 | 1.08 | 0.820 | |
| Obesity | 0.87 | 0.79 | 0.95 | 0.002 | 0.83 | 0.77 | 0.89 | <0.001 | |
| OSA | 0.90 | 0.81 | 1.00 | 0.055 | 0.97 | 0.89 | 1.06 | 0.465 | |
| Anemia | 1.15 | 1.07 | 1.24 | <0.001 | 1.32 | 1.24 | 1.40 | <0.001 | |
| Tobacco | 1.02 | 0.95 | 1.09 | 0.677 | 1.00 | 0.94 | 1.06 | 0.995 | |
| Alcohol | 1.01 | 0.88 | 1.15 | 0.919 | 0.91 | 0.81 | 1.03 | 0.134 | |
| CCI∥ | |||||||||
| 1 | Referent | Referent | |||||||
| 2 | 0.90 | 0.81 | 1.01 | 0.076 | 1.13 | 1.03 | 1.24 | 0.007 | |
| ≥3 | 1.13 | 1.01 | 1.26 | 0.041 | 1.40 | 1.27 | 1.53 | <0.001 | |
| Disposition | |||||||||
| Home | Referent | Referent | |||||||
| Facility/Others | 1.18 | 1.09 | 1.28 | <0.001 | 1.32 | 1.24 | 1.41 | <0.001 | |
| Length of stay | 0.99 | 0.99 | 1.00 | 0.049 | 1.01 | 1.01 | 1.01 | <0.001 | |
aOR = adjusted odds ratio; CI = confidence interval; LL = lower limit; UL = upper limit; PVD = peripheral vascular disease; CAD = coronary artery disease; TIA = transient ischemic attack; CABG = coronary artery bypass graft; PCI = percutaneous coronary intervention; FH = family history; COPD = chronic obstructive pulmonary disease; CKD = chronic kidney disease; OSA = obstructive sleep apnea; CCI = Charlson comorbidity index.
(H)Patients readmitted because of heart failure, and non-heart failure-related readmissions were excluded.
(NH)Patients readmitted because of non-heart failure, and heart failure-related readmissions were excluded.
*Represents a quartile classification of the estimated median household income of residents within the patient’s zip code, https://www.hcup-us.ahrq.gov/db/vars/zipinc_qrtl/nrdnote.jsp.
†The bed size cutoff points divided into small, medium, and large have been done so that approximately one-third of the hospitals in a given region, location, and teaching status combination would fall within each bed size category, https://www.hcup-us.ahrq.gov/db/vars/hosp_bedsize/nrdnote.jsp.
‡A hospital is considered to be a teaching hospital if it has an American Medical Association-approved residency program, https://www.hcup-us.ahrq.gov/db/vars/hosp_ur_teach/nrdnote.jsp.
§International Classification of Diseases, Tenth Revision codes were utilized to identify respective co-morbidities as per Supplementary Table 1.
∥CCI/Deyo comorbidity index was calculated as per Deyo classification.