Table 3.
Multinomial regression models for factors associated with frequent emergency department visits for acute exacerbation of chronic obstructive pulmonary disease, stratified by state
| |
California |
Florida |
||||||
|---|---|---|---|---|---|---|---|---|
| |
2 (vs. 1) ED visits |
≥ 3 (vs. 1) ED visits |
2 (vs. 1) ED visits |
≥ 3 (vs. 1) ED visits |
||||
| Variables | Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value |
| Age, y |
|
|
|
|
|
|
|
|
| 40-54 years |
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
| 55-64 years |
1.20 (1.11-1.31) |
<0.001 |
1.32 (1.21-1.45) |
<0.001 |
1.11 (1.03-1.21) |
0.008 |
1.28 (1.17-1.41) |
<0.001 |
| 65-74 years |
1.17 (1.07-1.29) |
0.001 |
1.16 (1.04-1.29) |
0.008 |
1.13 (1.03-1.23) |
0.01 |
1.05 (0.95-1.17) |
0.34 |
| 75-84 years |
1.15 (1.04-1.27) |
0.007 |
0.90 (0.80-1.01) |
0.08 |
0.98 (0.89-1.08) |
0.73 |
1.81 (0.73-0.91) |
<0.001 |
| 85 years and older |
0.99 (0.88-1.11) |
0.83 |
0.61 (0.53-0.70) |
<0.001 |
0.85 (0.76-0.96) |
0.007 |
0.54 (0.47-0.63) |
<0.001 |
| Male sex |
1.05 (1.00-1.10) |
0.048 |
1.13 (1.06-1.19) |
<0.001 |
1.03 (0.98-1.08) |
0.30 |
1.11 (1.05-1.18) |
<0.001 |
| Race/ethnicity |
|
|
|
|
|
|
|
|
| Non-hispanic white |
1.15 (1.06-1.25) |
0.001 |
1.32 (1.20-1.46) |
<0.001 |
1.13 (1.03-1.23) |
0.004 |
1.30 (1.17-1.44) |
<0.001 |
| Non-hispanic black |
1.24 (1.11-1.38) |
0.001 |
1.71 (1.51-1.93) |
<0.001 |
1.12 (1.01-1.25) |
0.04 |
1.49 (1.31-1.69) |
<0.001 |
| Hispanic |
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
| Other |
1.23 (1.00-1.28) |
0.06 |
1.16 (0.99-1.35) |
0.06 |
0.85 (0.65-1.10) |
0.21 |
0.80 (0.57-1.12) |
0.20 |
| Insurance status |
|
|
|
|
|
|
|
|
| Medicare |
1.55 (1.41-1.71) |
<0.001 |
1.88 (1.67-2.11) |
<0.001 |
1.63 (1.47-1.81) |
<0.001 |
2.41 (2.11-2.75) |
<0.001 |
| Medicaid |
1.65 (1.48-1.83) |
<0.001 |
2.58 (2.29-2.92) |
<0.001 |
1.96 (1.75-2.20) |
<0.001 |
3.38 (2.93-3.89) |
<0.001 |
| Private |
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
| Self-pay |
1.10 (0.95-1.28) |
0.21 |
1.05 (0.87-1.27) |
0.62 |
1.13 (0.98-1.29) |
0.09 |
1.11 (0.92-1.33) |
0.29 |
| Other |
1.34 (1.14-1.57) |
<0.001 |
1.34 (1.10-1.62) |
0.004 |
1.58 (1.37-1.81) |
<0.001 |
2.25 (1.90-2.67) |
<0.001 |
| Quartiles for median household income of patient’s ZIP code | ||||||||
| 1 (lowest) |
1.24 (1.13-1.37) |
<0.001 |
1.18 (1.09-1.28) |
<0.001 |
1.10 (1.01-1.19) |
0.03 |
1.22 (1.11-1.34) |
<0.001 |
| 2 |
1.22 (1.12-1.32) |
<0.001 |
1.24 (1.13-1.37) |
<0.001 |
1.03 (0.95-1.11) |
0.49 |
1.19 (1.08-1.31) |
<0.001 |
| 3 |
1.12 (1.03-1.21) |
0.001 |
1.20 (1.09-1.33) |
<0.001 |
1.04 (0.95-1.13) |
0.40 |
1.07 (0.97-1.19) |
0.19 |
| 4 (highest) |
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
| Patient residence |
|
|
|
|
|
|
|
|
| Counties of ≥ 1 million population |
1.00 (0.89-1.12) |
0.99 |
0.97 (0.86-1.11) |
0.69 |
1.10 (1.01-1.20) |
0.03 |
1.16 (1.04-1.28) |
0.005 |
| Counties of 250,000-999,999 population |
1.06 (0.94-1.20) |
0.34 |
1.02 (0.89-1.17) |
0.78 |
1.07 (0.98-1.17) |
0.16 |
1.09 (0.98-1.22) |
0.10 |
| Counties of 50,000-249,999 population |
1.01 (0.87-1.06) |
0.92 |
1.04 (0.89-1.22) |
0.65 |
1.16 (1.02-1.32) |
0.02 |
1.10 (0.94-1.28) |
0.23 |
| Counties of < 50,000 population |
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
1 [reference] |
|
| Selected comorbidities |
|
|
|
|
|
|
|
|
| Congestive heart failure |
1.16 (1.09-1.23) |
<0.001 |
1.27 (1.18-1.36) |
<0.001 |
1.18 (1.11-1.26) |
<0.001 |
1.22 (1.13-1.31) |
<0.001 |
| Pulmonary circulation disorders |
1.51 (1.22-1.86) |
<0.001 |
1.34 (1.04-1.73) |
0.02 |
1.29 (1.05-1.60) |
0.02 |
1.37 (1.09-1.73) |
0.008 |
| Diabetes, uncomplicated |
1.02 (0.96-1.09) |
0.47 |
1.14 (1.06-1.23) |
<0.001 |
1.08 (1.02-1.15) |
0.009 |
1.12 (1.05-1.20) |
<0.001 |
| Obesity |
1.01 (0.92-1.10) |
0.85 |
0.96 (0.87-1.06) |
0.42 |
0.98 (0.91-1.06) |
0.60 |
0.97 (0.89-1.06) |
0.50 |
| Depression |
1.22 (1.11-1.33) |
<0.001 |
1.39 (1.26-1.54) |
<0.001 |
1.19 (1.10-1.28) |
<0.001 |
1.37 (1.26-1.49) |
<0.001 |
| Psychoses |
1.19 (1.07-1.32) |
0.001 |
1.26 (1.13-1.42) |
<0.001 |
1.16 (1.04-1.29) |
0.01 |
1.28 (1.14-1.45) |
<0.001 |
| Drug abuse | 1.27 (1.10-1.47) | 0.001 | 1.72 (1.49-1.97) | <0.001 | 1.16 (0.97-1.39) | 0.10 | 1.55 (1.30-1.86) | <0.001 |
Abbreviations: COPD chronic obstructive pulmonary disease, ED emergency department, CI confidence interval.
Bold results are statistically significant.