TABLE 4.
Logistic Regression Analysis of Dying in the Residence (vs. Hospital) by End-of-Life Residence
| Community Residents |
Nursing Home Residents |
|||||||
|---|---|---|---|---|---|---|---|---|
| Full Sample N = 1615 |
Expected Deaths§ N = 855 |
Full Sample N = 913 |
Expected Deaths§ N = 628 |
|||||
| Odds | (SE) | Odds | (SE) | Odds | (SE) | Odds | (SE) | |
| Sociodemographic characteristics | ||||||||
| Age (yrs) | 1.032† | (0.010) | 1.068‡ | (0.014) | 1.023 | (0.017) | 1.024 | (0.022) |
| Female | 0.936 | (0.105) | 1.323 | (0.220) | 1.065 | (0.217) | 0.972 | (0.201) |
| Black | 0.785 | (0.133) | 0.436† | (0.120) | 0.623* | (0.138) | 0.360‡ | (0.087) |
| Hispanic | 1.014 | (0.198) | 1.077 | (0.290) | 0.385‡ | (0.090) | 0.347* | (0.163) |
| Education (yrs) | 1.002 | (0.018) | 0.986 | (0.024) | 1.015 | (0.029) | 1.011 | (0.033) |
| Income (low = reference) | ||||||||
| Middle | 1.092 | (0.186) | 1.493 | (0.355) | 0.769 | (0.166) | 0.996 | (0.260) |
| High | 1.056 | (0.236) | 2.151* | (0.687) | 0.629 | (0.164) | 0.779 | (0.335) |
| Wealth (low = reference) | ||||||||
| Middle | 1.128 | (0.173) | 1.150 | (0.190) | 1.111 | (0.332) | 1.062 | (0.375) |
| High | 1.177 | (0.194) | 0.832 | (0.168) | 1.614 | (0.498) | 1.155 | (0.516) |
| Medicaid | 0.897 | (0.219) | 0.893 | (0.271) | 0.989 | (0.190) | 0.795 | (0.237) |
| Underlying cause of death | ||||||||
| Cardiovascular disease | 0.737* | (0.101) | 0.365‡ | (0.087) | 0.350† | (0.122) | 0.324* | (0.147) |
| Other chronic conditions | 0.211‡ | (0.062) | 0.135‡ | (0.052) | 0.242† | (0.116) | 0.241* | (0.153) |
| Acute conditions | 0.573† | (0.114) | 0.355‡ | (0.082) | 0.205‡ | (0.093) | 0.212† | (0.122) |
| Unknown | 0.542‡ | (0.123) | 0.503‡ | (0.204) | 0.625† | (0.316) | 0.990* | (0.699) |
| Other | 0.424† | (0.083) | 0.276 | (0.076) | 0.311 | (0.119) | 0.342 | (0.159) |
| Timing of death | ||||||||
| Death expected | 1.290* | (0.167) | 1.734* | (0.376) | ||||
| Final illness (>1 mo = reference) | ||||||||
| <1 d | 2.019‡ | (0.326) | 0.760 | (0.264) | 0.631 | (0.152) | 0.500 | (0.243) |
| <1 mo | 0.236‡ | (0.032) | 0.374‡ | (0.063) | 0.296‡ | (0.042) | 0.305‡ | (0.051) |
| End-of-life health status | ||||||||
| No. ADL∥ limitations in the last 3 mo | 1.082‡ | (0.021) | 1.178‡ | (0.048) | 1.088 | (0.048) | 1.180‡ | (0.059) |
| Any ADL∥ lasting >1 yr | 1.074 | (0.248) | 1.414 | (0.411) | 1.275 | (0.313) | 1.446 | (0.383) |
| Temper | 0.976 | (0.146) | 1.315 | (0.193) | 1.621* | (0.383) | 1.199 | (0.395) |
| Confused | 1.274 | (0.227) | 1.118 | (0.217) | 0.787 | (0.186) | 0.906 | (0.239) |
| Severe pain | 0.946 | (0.136) | 1.043 | (0.240) | 0.687 | (0.139) | 0.696 | (0.142) |
| No. diseases | 0.820‡ | (0.046) | 0.851 | (0.085) | 0.839 | (0.078) | 0.817 | (0.102) |
| Cognitive impairment¶ | 1.016 | (0.019) | 1.017 | (0.022) | 1.063* | (0.026) | 1.024 | (0.038) |
| Family availability | ||||||||
| Married | 1.098 | (0.136) | 1.145 | (0.284) | 1.347 | (0.320) | 1.127 | (0.371) |
| No. children | 1.037 | (0.030) | 1.064 | (0.037) | 1.021 | (0.058) | 1.039 | (0.067) |
| Live alone | 0.885 | (0.091) | 0.813 | (0.152) | 0.848 | (0.190) | 0.849 | (0.283) |
| Control variables | ||||||||
| Year of death | 0.982 | (0.033) | 1.023 | (0.049) | 1.051 | (0.042) | 1.047 | (0.043) |
| Years since previous survey | 1.042 | (0.081) | 0.994 | (0.101) | 0.985 | (0.109) | 0.940 | (0.130) |
| County-level resources | ||||||||
| Nursing home beds/1000 65+ | 1.000 | (0.003) | 0.997 | (0.004) | 1.006 | (0.005) | 1.001 | (0.006) |
| Home health agencies/10,000 65+ | 0.995 | (0.020) | 0.987 | (0.030) | 0.986 | (0.026) | 1.014 | (0.031) |
| Hospital beds/1000 65+ | 0.972 | (0.025) | 0.942 | (0.034) | 0.998 | (0.052) | 1.004 | (0.048) |
| Physicians/1000 65+ | 1.032 | (0.113) | 1.187 | (0.193) | 0.832 | (0.108) | 0.759 | (0.147) |
| % Specialist physicians | 0.997 | (0.006) | 0.989 | (0.010) | 1.014 | (0.008) | 1.023 | (0.010) |
| State-level HCBS | ||||||||
| HCBS** $/65+ (logged) | 1.057 | (0.089) | 0.970 | (0.098) | 0.907 | (0.095) | 0.982 | (0.167) |
*
P ≤ 0.05.
†
P ≤ 0.01.
‡
P ≤ 0.001.
§
Based on the proxy informant’s response to the question, “Was the death expected at about the time it occurred, or was it unexpected?”
∥
Activities of daily living.
¶
Sum of 3 cognition variables assessing memory, judgment, and organization (each assessed on a scale of 1-5; ie, excellent to poor; range, 3-15).
**
Home- and community-based services.