Table 3.
Multivariate Regression Models Predicting Hospice Utilization
| Dependent variable | Hospice use | Length of hospice use | ||||||
|---|---|---|---|---|---|---|---|---|
| n = 3,752 | n = 694 | |||||||
| Independent variable | Odds ratio | 95% Confidence interval | p Value | Exp(beta)a | 95% Confidence interval | p Value | ||
| Facility characteristic | ||||||||
| Tendency to offer hospice | 2.760 | 1.135 | 6.716 | .025b | 1.671 | 0.663 | 4.209 | .276c |
| Tendency to offer hospice ^2 | 0.853 | 0.748 | 0.972 | .017b | 0.915 | 0.795 | 1.053 | .214c |
| Tendency to hospitalize | 0.679 | 0.532 | 0.866 | .002 | 0.734 | 0.529 | 1.018 | .064 |
| Feeding tube initiation | 1.459 | 1.132 | 1.880 | .003 | 0.974 | 0.757 | 1.255 | .841 |
| Religious affiliation | 2.004 | 1.296 | 3.099 | .002 | 1.492 | 1.033 | 2.153 | .033 |
| Percent of Black residents (per 1% increase) | 0.985 | 0.968 | 1.002 | .074 | 0.981 | 0.952 | 1.010 | .203 |
| CMS case-mix index (per 0.1 increase) | 0.887 | 0.709 | 1.110 | .296 | 0.909 | 0.688 | 1.203 | .506 |
| Licensed practical nurses (LPN) and certified nurse aides (CNA) hour per resident day | 5.422 | 3.035 | 9.687 | <.001 | 1.551 | 1.175 | 2.047 | .002 |
| RN to LPN and CNA ratio (per 1% increase) | 0.997 | 0.944 | 1.053 | .912 | 1.022 | 0.984 | 1.061 | .268 |
| Percent of Medicaid residents (ref group) | ||||||||
| Percent of Medicare residents (per 1% increase) | 1.075 | 1.044 | 1.106 | <.001 | 0.994 | 0.961 | 1.028 | .729 |
| Percent of private-pay residents (per 1% increase) | 0.995 | 0.976 | 1.015 | .644 | 0.986 | 0.963 | 1.009 | .232 |
| Size | 1.001 | 1.000 | 1.003 | .129 | 1.000 | 0.999 | 1.002 | .782 |
| For-profit facility | 0.707 | 0.456 | 1.098 | .122 | 1.101 | 0.757 | 1.602 | .615 |
| Chain membership | 0.635 | 0.375 | 1.072 | .089 | 0.788 | 0.315 | 1.968 | .609 |
| Individual characteristic | ||||||||
| Age | 0.989 | 0.975 | 1.003 | .116 | 1.025 | 0.999 | 1.051 | .061 |
| Race (ref = White) | ||||||||
| Black | 0.535 | 0.336 | 0.852 | .008 | 0.926 | 0.261 | 3.279 | .905 |
| Other | 0.540 | 0.302 | 0.964 | .037 | 0.338 | 0.101 | 1.128 | .078 |
| Married | 1.405 | 1.067 | 1.852 | .016 | 0.755 | 0.376 | 1.517 | .430 |
| Men | 0.745 | 0.589 | 0.943 | .014 | 0.392 | 0.196 | 0.782 | .008 |
| Do not resuscitate | 1.791 | 1.336 | 2.400 | <.001 | 0.879 | 0.548 | 1.412 | .595 |
| Do not hospitalize | 0.805 | 0.549 | 1.179 | .265 | 1.032 | 0.653 | 1.630 | .894 |
| Diabetes | 0.907 | 0.712 | 1.155 | .428 | 0.810 | 0.511 | 1.283 | .369 |
| Congestive heart failure | 0.613 | 0.477 | 0.787 | <.001 | 0.855 | 0.680 | 1.076 | .182 |
| Dementia | 1.253 | 1.017 | 1.545 | .034 | 0.863 | 0.572 | 1.303 | .484 |
| Chronic obstructive pulmonary disease | 0.580 | 0.435 | 0.774 | <.001 | 1.569 | 0.817 | 3.014 | .176 |
| Cancer | 2.105 | 1.621 | 2.734 | <.001 | 0.577 | 0.304 | 1.095 | .092 |
| Renal failure | 0.580 | 0.398 | 0.846 | .005 | 0.331 | 0.089 | 1.230 | .099 |
| Depression | 1.466 | 1.167 | 1.841 | .001 | 0.954 | 0.762 | 1.193 | .678 |
| End-stage diagnosis | 2.841 | 1.901 | 4.246 | <.001 | 1.492 | 0.951 | 2.341 | .082 |
| Fracture in the last 180 days | 0.999 | 0.658 | 1.518 | .996 | 1.904 | 0.991 | 3.659 | .053 |
| Severe pain | 1.299 | 0.967 | 1.746 | .082 | 0.611 | 0.323 | 1.158 | .131 |
| Dyspnea | 0.853 | 0.614 | 1.187 | .347 | 0.604 | 0.328 | 1.110 | .104 |
| Activities of daily living (per score increase) | 1.011 | 0.990 | 1.032 | .309 | 1.038 | 0.989 | 1.089 | .132 |
| Severe cognitive impairment | 0.765 | 0.586 | 0.997 | .048 | 1.593 | 1.082 | 2.344 | .018 |
| Nursing home length of stay (ref = less than 92 days) | ||||||||
| Longer than 92 days | 1.089 | 0.817 | 1.450 | .560 | 1.253 | 0.643 | 2.440 | .508 |
| C-stat = 0.842 | R 2 = .361 | |||||||
aExp(beta) presents the magnitude of multiplicative effect of one unit increase in a predictor on the dependent variable.
bJoint likelihood ratio (LR) test result significant p = .048.
cJoint LR test result not significant p = .398.