Table 5.
Adjusted Rate Ratios for Association of Geographic Factors Influencing Inpatient Services With Palliative-Care Intent in the Last 12 Months of Life
| Adjusted rate ratio (95% confidence interval) |
||||
|---|---|---|---|---|
| |
Sensitivity analysis |
|||
| Inpatient PC (hospital admission coded as palliative care) | Inpatient SPC (hospital admission occurring either under a PC specialist &/or in a SPC ward) | Inpatient PC (received before last stay) | Inpatient SPC (received before last stay) | |
| Characteristics | ||||
| MM index | ||||
| Metropolitan | 1.0 | 1.0 | 1.0 | 1.0 |
| Regional centers | 0.851 (0.746–0.971) | 1.114 (0.866–1.433) | 0.754 (0.600–0.947) | 0.853 (0.506–1.437) |
| Large rural towns | 0.959 (0.896–1.026) | 1.108 (0.950–1.292) | 0.940 (0.837–1.056) | 1.157 (0.859–1.558) |
| Medium rural towns | 1.008 (0.868–1.171) | 0.924 (0.616–1.386) | 0.984 (0.760–1.274) | 1.091 (0.535–2.224) |
| Small rural towns | 0.892 (0.780–1.021) | 1.098 (0.702–1.717) | 0.825 (0.655–1.038) | 0.759 (0.326–1.765) |
| Travel time (mins)a | PC facility | (SPC facility) | PC facility | (SPC facility) |
| 0–<5 | 1.0 | 1.0 | 1.0 | 1.0 |
| 5–<10 | 1.000 (0.933–1.071) | 0.875 (0.752–1.018) | 0.986 (0.877–1.110) | 0.742 (0.522–1.054) |
| 10–<15 | 1.038 (0.982–1.098) | 0.996 (0.891–1.114) | 1.056 (0.961–1.161) | 1.276 (1.001–1.626) |
| 15–<30 | 1.045 (0.961–1.135) | 0.957 (0.823–1.112) | 1.105 (0.962–1.270) | 1.477 (1.098–1.986) |
| 30+ | 0.965 (0.828–1.126) | 0.723 (0.476–1.098) | 0.949 (0.728–1.237) | 0.761 (0.357–1.623) |
Where p < 0.05, figures are in bold.
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.
a
Nearest facility with health service (e.g., emergency department, intensive care unit, specialist palliative care facility/ward).
PC, palliative care; SPC, specialist palliative care.