Table 2.
Model 4: All Patient Characteristics | Model 5: Hospital Characteristics Added | |||||
---|---|---|---|---|---|---|
OR | P | 95% CI | OR | P | 95% CI | |
Patient characteristics | ||||||
Race/ethnicity | ||||||
White | 1.00 | – | 1.00 | – | ||
Black | 1.23 | <.001 | 1.16 to 1.31 | 0.95 | .05 | 0.91 to 1.00 |
Hispanic | 0.90 | .03 | 0.82 to 0.99 | 0.66 | <.001 | 0.62 to 0.70 |
Asian | 0.76 | <.001 | 0.69 to 0.84 | 0.60 | <.001 | 0.55 to 0.65 |
Other | 0.95 | .49 | 0.81 to 1.10 | 0.69 | <.001 | 0.61 to 0.78 |
Missing | 0.88 | .24 | 0.72 to 1.09 | 0.72 | .001 | 0.60 to 0.87 |
Female gender | 0.62 | <.001 | 0.61 to 0.63 | 0.62 | <.001 | 0.61 to 0.63 |
Patient age | 0.84 | <.001 | 0.83 to 0.84 | 0.83 | <.001 | 0.82 to 0.84 |
Patient age squared | 0.997 | <.001 | 0.997 to 0.998 | 0.997 | <.001 | 0.997 to 0.998 |
Elective admission | 0.23 | <.001 | 0.21 to 0.26 | 0.24 | <.001 | 0.22 to 0.27 |
Primary payer | ||||||
Private insurance | 1.00 | – | 1.00 | – | ||
Self-pay | 3.39 | <.001 | 3.16 to 3.62 | 3.08 | <.001 | 2.89 to 3.29 |
Medicare | 1.97 | <.001 | 1.89 to 2.05 | 1.96 | <.001 | 1.89 to 2.03 |
Medicaid | 3.15 | <.001 | 2.99 to 3.32 | 2.81 | <.001 | 2.66 to 2.96 |
Other | 1.60 | <.001 | 1.45 to 1.77 | 1.57 | <.001 | 1.44 to 1.70 |
Patient median Zip code income | ||||||
<$32,000 | 1.47 | <.001 | 1.33 to 1.63 | 1.30 | <.001 | 1.19 to 1.42 |
$32,000 to <$40,000 | 1.20 | <.001 | 1.10 to 1.32 | 1.15 | .001 | 1.06 to 1.25 |
$40,000 to <$53,000 | 1.16 | <.001 | 1.07 to 1.25 | 1.12 | .001 | 1.05 to 1.20 |
$53,000+ | 1.00 | – | 1.00 | – | ||
Missing patient Zip code | 1.83 | <.001 | 1.69 to 1.99 | 1.80 | <.001 | 1.67 to 1.95 |
Hospital attributes | ||||||
Log of total annual discharges | 0.85 | <.001 | 0.80 to 0.90 | |||
Herfindahl Index* | 1.01 | .15 | 1.00 to 1.02 | |||
Hospital ownership | ||||||
Not-for-profit | 1.00 | – | ||||
Public | 0.95 | .47 | 0.84 to 1.09 | |||
Private | 1.20 | <.001 | 1.09 to 1.33 | |||
Teaching hospital | 1.06 | .04 | 1.00 to 1.13 | |||
Hospital utilization rate | ||||||
Quartile 1 | 1.00 | – | ||||
Quartile 2 | 1.02 | .73 | 0.92 to 1.12 | |||
Quartile 3 | 1.07 | .28 | 0.94 to 1.22 | |||
Quartile 4 | 0.94 | .33 | 0.84 to 1.06 | |||
Hospital environment | ||||||
Hospital MSA size | ||||||
Nonmetropolitan | 1.74 | <.001 | 1.57 to 1.93 | |||
<1 M | 1.28 | <.001 | 1.17 to 1.41 | |||
1 M to 2.5 M | 1.00 | – | ||||
>2.5 M | 1.02 | .80 | 0.89 to 1.16 | |||
Hospital percent Medicaid discharges† | 1.03 | .001 | 1.01 to 1.05 | |||
Hospital percent Nonwhite discharges‡ | 1.03 | <.001 | 1.02 to 1.04 |
Models also adjusted for individual patient co-morbidities, year of discharge, and state (not shown). ORs for age are for 5-year increments in age.
The Herfindahl index (0 to 1) is multiplied by 100. (Sample inter-quartile range 6 to 12.)
ORs for percent Medicaid discharges are for 5% increments in hospital percent Medicaid discharges.
ORs for percent nonwhites discharges are for 5% increments in hospital percent nonwhite discharges.
DAMA, discharged against medical advice; OR, odds ratio; CI, confidence intervals.