Table 4.
Adjusted Rate Ratios for Association of Geographic Factors Influencing Inpatient Services in the Last 12 Months of Life
| Adjusted rate ratio (95% confidence interval) |
||||||
|---|---|---|---|---|---|---|
| ≥1 Acute hospitalization | ≥1 ED visit | ≥1 ICU admission | ≥1 Mechanical ventilation | ≥1 Chemotherapy treatment^ | ≥1 Radiotherapy treatmenta | |
| Characteristics | ||||||
| MM index | ||||||
| Metropolitan | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
| Regional centers | 0.858 (0.726–1.014) | 0.876 (0.745–1.032) | 1.208 (0.761–1.918) | 2.198 (1.299–3.719) | 1.208 (0.824–1.770) | 0.534 (0.303–0.942) |
| Large rural towns | 0.825 (0.756–0.900)b | 1.067 (0.973–1.171) | 1.317 (1.026–1.692) | 0.951 (0.697–1.298) | 0.915 (0.730–1.146) | 0.320 (0.231–0.444)b |
| Medium rural towns | 0.947 (0.801–1.119) | 1.660 (1.478–1.865) | 1.174 (0.734–1.880) | 1.695 (0.985–2.917) | 0.890 (0.568–1.394) | 0.367 (0.193–0.699) |
| Small rural towns | 0.888 (0.758–1.040) | 1.294 (1.065–1.571) | 1.486 (0.965–2.286) | 2.020 (1.211–3.368) | 0.669 (0.435–1.029) | 0.071 (0.028–0.180)b |
| Travel time (mins)c | ||||||
| 0–<5 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 |
| 5–<10 | 1.025 (0.932–1.127) | 1.066 (0.986–1.153) | 1.155 (0.849–1.572) | 0.831 (0.590–1.169) | 0.969 (0.740–1.268) | 0.737 (0.556–0.975) |
| 10–<15 | 1.048 (0.957–1.147) | 0.985 (0.899–1.079) | 1.282 (0.953–1.724) | 0.708 (0.501–1.001) | 0.892 (0.684–1.164) | 0.914 (0.710–1.176) |
| 15–<30 | 0.973 (0.890–1.064) | 0.930 (0.805–1.075) | 1.212 (0.910–1.616) | 0.834 (0.605–1.151) | 1.186 (0.931–1.510) | 1.009 (0.793–1.285) |
| 30+ | 0.967 (0.818–1.143) | 0.670 (0.583–0.769)b | 1.128 (0.703–1.811) | 0.580 (0.337–1.000) | 0.853 (0.540–1.348) | 0.956 (0.516–1.773) |
a
Inpatient chemotherapy and inpatient radiotherapy services have been included in this table for convenience, and not necessarily categorized as services with acute-care intent.
Where p < 0.05, figures are in bold, bindicates statistical significance (p < 0.0001).
Adjusted for sex, age at death, marital status, preferred language, cancer type, comorbidity index, socioeconomic status, rate ratio from negative binomial regression for health care utilization with count data.
c
Nearest facility with health service (e.g., emergency department, intensive care unit, specialist palliative care unit).