Table 2.
Multinomial regression models for factors associated with frequent emergency department visits for acute exacerbation of chronic obstructive pulmonary disease
| |
2 (vs. 1) ED visits |
≥ 3 (vs. 1) ED visits |
||
|---|---|---|---|---|
| Variables | Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value |
| Age, y |
|
<0.001 |
|
<0.001 |
| 40-54 years |
1 [reference] |
|
1 [reference] |
|
| 55-64 years |
1.15 (1.09-1.22) |
<0.001 |
1.31 (1.23-1.39) |
<0.001 |
| 65-74 years |
1.14 (1.07-1.22) |
<0.001 |
1.11 (1.03-1.20) |
0.006 |
| 75-84 years |
1.05 (0.98-1.12) |
0.10 |
0.86 (0.79-0.93) |
<0.001 |
| 85 years and older |
0.90 (0.83-0.97) |
0.03 |
0.58 (0.52-0.64) |
<0.001 |
| Male sex |
1.04 (1.00-1.08) |
0.048 |
1.12 (1.07-1.17) |
<0.001 |
| Race/ethnicity |
|
|
|
|
| Non-hispanic white |
1.15 (1.08-1.21) |
<0.001 |
1.32 (1.23-1.41) |
<0.001 |
| Non-hispanic black |
1.17 (1.09-1.27) |
<0.001 |
1.59 (1.46-1.73) |
<0.001 |
| Hispanic |
1 [reference] |
|
1 [reference] |
|
| Other |
1.07 (0.96-1.19) |
0.29 |
1.07 (0.96-1.19) |
0.33 |
| Insurance status |
|
|
|
|
| Medicare |
1.58 (1.47-1.69) |
<0.001 |
2.10 (1.92-2.29) |
<0.001 |
| Medicaid |
1.77 (1.64-1.92) |
<0.001 |
2.92 (2.66-3.20) |
<0.001 |
| Private |
1 [reference] |
|
1 [reference] |
|
| Self-pay |
1.11 (1.00-1.23) |
0.046 |
1.05 (0.92-1.20) |
0.45 |
| Other |
1.46 (1.32-1.62) |
<0.001 |
1.78 (1.57-2.02) |
<0.001 |
| Quartiles for median household income of patient’s ZIP code |
|
|
||
| 1 (lowest) |
1.13 (1.07-1.20) |
<0.001 |
1.29 (1.21-1.38) |
<0.001 |
| 2 |
1.11 (1.05-1.18) |
<0.001 |
1.22 (1.14-1.31) |
<0.001 |
| 3 |
1.08 (1.01-1.14) |
0.01 |
1.14 (1.06-1.22) |
<0.001 |
| 4 (highest) |
1 [reference] |
|
1 [reference] |
|
| Patient residence |
|
|
|
|
| Counties of ≥ 1 million population |
1.07 (1.00-1.15) |
0.06 |
1.09 (1.01-1.18) |
0.03 |
| Counties of 250,000-999,999 population |
1.07 (1.00-1.15) |
0.07 |
1.09 (1.00-1.18) |
0.06 |
| Counties of 50,000-249,999 population |
1.09 (1.00-1.20) |
0.06 |
1.10 (0.99-1.23) |
0.09 |
| Counties of < 50,000 population |
1 [reference] |
|
1 [reference] |
|
| State |
|
|
|
|
| California |
1.01 (0.98-1.05) |
0.44 |
1.06 (1.02-1.11) |
0.006 |
| Florida |
1 [reference] |
|
1 [reference] |
|
| Selected comorbidities* |
|
|
|
|
| Congestive heart failure |
1.17 (1.11-1.22) |
<0.001 |
1.24 (1.17-1.30) |
<0.001 |
| Pulmonary circulation disorders |
1.41 (1.22-1.64) |
<0.001 |
1.39 (1.17-1.64) |
<0.001 |
| Diabetes, uncomplicated |
1.05 (1.01-1.10) |
0.02 |
1.13 (1.07-1.19) |
<0.001 |
| Obesity |
0.99 (0.94-1.05) |
0.79 |
0.97 (0.91-1.03) |
0.31 |
| Depression |
1.21 (1.14-1.28) |
<0.001 |
1.38 (1.30-1.47) |
<0.001 |
| Psychoses |
1.17 (1.09-1.27) |
<0.001 |
1.27 (1.17-1.38) |
<0.001 |
| Drug abuse | 1.22 (1.09-1.37) | <0.001 | 1.66 (1.48-1.85) | <0.001 |
Abbreviations: COPD chronic obstructive pulmonary disease, ED emergency department, CI confidence interval.
Bold results are statistically significant.
*Non-significant Elixhauser comorbidity measures across the frequency groups included peripheral vascular disease, hypertension, neurological disorders, diabetes with complications, liver disease, peptic ulcer disease, acquired immunodeficiency syndrome, lymphoma, solid tumor without metastasis, coagulopathy, fluid and electrolyte disorders, anemia, and alcohol abuse.