Table 3.
Logistic Regression Results, Michigan Dually Eligible Nursing Home Residents, 1997–2000, Marginal Effects‡ and Robust Standard Errors
| Diagnosis at Death or Same Month as Death (n=1,316) |
Pain Medication in Month of or after Cancer Diagnosis (n=973) |
|||||
|---|---|---|---|---|---|---|
| All BBA Variables | Post-BBA only | BBA Phase- In Only | All BBA Variables | Post-BBA Only | BBA Phase- In Only | |
| Variables | dy/dx (Robust SE) | dy/dx (Robust SE) | dy/dx (Robust SE) | dy/dx (Robust SE) | dy/dx (Robust SE) | dy/dx (Robust SE) |
| Organizational characteristics | ||||||
| Nursing hours/patient day | −0.029* | −0.028* | −0.027* | 0.004 | 0.004 | 0.007 |
| (0.014) | (0.013) | (0.014) | (0.018) | (0.019) | (0.018) | |
| Ownership | ||||||
| NFP (referent) | — | — | — | — | — | — |
| For-profit ownership | 0.017 | 0.015 | 0.014 | 0.052 | 0.050 | 0.049 |
| (0.030) | (0.031) | (0.030) | (0.038) | (0.039) | (0.038) | |
| Government ownership | 0.087 | 0.092 | 0.106† | 0.040 | 0.040 | 0.049 |
| (0.062) | (0.062) | (0.064) | (0.077) | (0.077) | (0.076) | |
| % Medicaid | −0.001 | −0.001 | −0.001 | −0.004*** | −0.004*** | −0.004*** |
| (0.001) | (0.001) | (0.001) | (0.001) | (0.001) | (0.001) | |
| % Medicare | −0.001 | −0.001 | −0.001 | −0.006** | −0.006** | −0.007** |
| (0.002) | (0.002) | (0.002) | (0.002) | (0.002) | (0.002) | |
| Occupancy | 0.003† | 0.003 | 0.002 | −0.003 | −0.003 | −0.003 |
| (0.002) | (0.002) | (0.002) | (0.003) | (0.002) | (0.002) | |
| Market characteristics | ||||||
| County Herfindahl index | −0.060 | −0.064 | −0.073 | 0.143 | 0.144 | 0.133 |
| (0.065) | (0.065) | (0.065) | (0.106) | (0.106) | (0.106) | |
| Short-term general hospital beds/1,000 population in county | −0.025* | −0.025* | −0.028* | −0.005 | −0.005 | −0.007 |
| (0.012) | (0.012) | (0.012) | (0.015) | (0.015) | (0.015) | |
| Post-Balanced Budget Act diagnosis | 0.110*** | 0.088*** | — | 0.077 | 0.085** | — |
| (0.030) | (0.018) | (0.054) | (0.033) | |||
| BBA phase-in | −0.076 | — | 0.090** | −0.014 | — | 0.133* |
| (0.069) | (0.032) | (0.099) | (0.067) | |||
| Diagnosed after BBRA | 0.025 | — | — | 0.042 | — | — |
| (0.035) | (0.043) | |||||
| Patient characteristics | ||||||
| Age (years) | ||||||
| 66–70 (referent) | — | — | — | — | — | — |
| 71–75 | −0.035 | −0.039 | −0.047 | −0.081 | −0.080 | −0.086 |
| (0.043) | (0.042) | (0.041) | (0.071) | (0.071) | (0.073) | |
| 76–80 | 0.007 | 0.004 | −0.002 | −0.097 | −0.098 | −0.102 |
| (0.056) | (0.055) | (0.057) | (0.072) | (0.072) | (0.073) | |
| 81–85 | 0.069 | 0.066 | −0.062 | −0.096† | −0.096† | −0.100† |
| (0.048) | (0.047) | (0.048) | (0.055) | (0.056) | (0.057) | |
| ≥86 | 0.124* | 0.120* | 0.116* | −0.157** | −0.157** | −0.159** |
| (0.051) | (0.050) | (0.051) | (0.057) | (0.057) | (0.058) | |
| Race | ||||||
| White (referent) | — | — | — | — | — | — |
| African American/other | −0.058† | −0.056† | −0.053† | −0.063 | −0.061 | −0.058 |
| (0.032) | (0.032) | (0.032) | (0.052) | (0.051) | (0.053) | |
| Sex | ||||||
| Male (referent) | — | — | — | — | — | — |
| Female | −0.004 | −0.005 | −0.007 | 0.073* | 0.073* | 0.070* |
| (0.031) | (0.031) | (0.032) | (0.031) | (0.031) | (0.031) | |
| Alzheimer's disease | 0.042* | 0.042* | 0.049* | 0.009 | 0.009 | 0.011 |
| (0.021) | (0.022) | (0.022) | (0.029) | (0.029) | (0.030) | |
| Stayed 31–90 days before diagnosis | −0.058 | −0.057 | −0.053 | −0.281*** | −0.280*** | −0.279*** |
| (0.055) | (0.055) | (0.055) | (0.047) | (0.046) | (0.048) | |
| Hospice | −0.144* | −0.143* | −0.143* | −0.104 | −0.106 | −0.097 |
| (0.058) | (0.059) | (0.063) | (0.091) | (0.090) | (0.088) | |
| Diagnosed at death | — | — | — | −0.094*** | −0.094*** | −0.088*** |
| (0.026) | (0.026) | (0.026) | ||||
| Cancer sites | ||||||
| Other (referent) | — | — | — | — | — | — |
| Breast | 0.002 | 0.003 | 0.001 | — | — | — |
| (0.042) | (0.043) | (0.044) | ||||
| Colorectal | 0.001 | 0.003 | 0.007 | — | — | — |
| (0.041) | (0.041) | (0.044) | ||||
| Lung | 0.085 | 0.086 | 0.094 | — | — | — |
| (0.062) | (0.062) | (0.063) | ||||
| Prostate | 0.167* | 0.166* | 0.163* | — | — | — |
| (0.070) | (0.070) | (0.071) | ||||
| Other gastrointestinal | 0.019 | 0.017 | 0.018 | — | — | — |
| (0.051) | (0.050) | (0.049) | ||||
| Pancreas | 0.076 | 0.078 | 0.085 | — | — | — |
| (0.073) | (0.073) | (0.073) | ||||
| Urinary bladder | −0.203*** | −0.203*** | −0.204*** | — | — | — |
| (0.030) | (0.030) | (0.030) | ||||
| Leukemias | 0.088 | 0.091 | 0.086 | — | — | — |
| (0.065) | (0.065) | (0.063) | ||||
| Wald's χ2 | 309.39 | 244.05 | 238.49 | 184.06 | 167.63 | 159.20 |
| Prob. χ2 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 |
Marginal effects at mean for continuous variables, for discrete change from 0 to 1 for binary variables.
p<.10.
p<.05.
p<.01.
p<.001.
BBA, Balanced Budget Act; BBRA, Balanced Budget Refinement Act.