Table 4: Adjusted odds of obtaining follow-up care from a family doctor, cardiologist or internist within 7 days of emergency department discharge among patients who had a family physician (n = 14 146).
Variable | OR (95% CI) | p value |
---|---|---|
Patient characteristics |
||
Age, per decade increase |
1.09 (1.06–1.12) |
< 0.001 |
Female |
1.05 (0.98–1.13) |
0.18 |
Income quintile; referent = 1, lowest |
||
2 |
1.07 (0.96–1.20) |
0.22 |
3 |
1.04 (0.93–1.16) |
0.53 |
4 |
0.95 (0.85–1.06) |
0.34 |
5 (highest) |
1.05 (0.94–1.17) |
0.40 |
Rural residence |
0.95 (0.85–1.07) |
0.44 |
Long-term care or nursing home residence |
0.77 (0.56–1.05) |
0.09 |
Immigrant |
1.18 (1.04–1.34) |
0.01 |
Past medical history; referent = 0 |
||
Hypertension, recent diagnosis (in the last yr) |
1.14 (0.92–1.40) |
0.23 |
Hypertension, diagnosis made before the last 1 yr |
1.15 (1.06–1.26) |
0.002 |
Heart failure, recent diagnosis (in the last yr) |
0.87 (0.65–1.14) |
0.31 |
Heart failure, diagnosis made before the last 1 yr |
0.75 (0.64–0.88) |
< 0.001 |
Acute myocardial infarction |
1.02 (0.92–1.14) |
0.68 |
Coronary artery disease |
0.83 (0.73–0.94) |
0.003 |
Coronary artery bypass graft |
1.09 (0.85–1.40) |
0.49 |
Stroke |
0.78 (0.65–0.94) |
0.01 |
Diabetes mellitus |
1.06 (0.96–1.17) |
0.24 |
Dementia |
0.84 (0.69–1.03) |
0.09 |
Chronic obstructive pulmonary disease |
1.03 (0.93–1.13) |
0.58 |
Asthma |
1.04 (0.94–1.15) |
0.44 |
Renal failure |
0.69 (0.57–0.83) |
< 0.001 |
Nonmetastatic cancer |
0.84 (0.76–0.94) |
0.002 |
Metastatic cancer |
0.94 (0.72–1.22) |
0.62 |
CHADS2 score ≥ 2; referent = 0 or 1 |
0.97 (0.87–1.09) |
0.65 |
ADG score per 1 point increase |
1.04 (1.03–1.05) |
< 0.001 |
Emergency department visit characteristics |
||
Emergency department triage score of 1 or 2 (high acuity); referent = 3, 4 or 5 |
1.02 (0.94–1.09) |
0.69 |
Patients who arrived by ambulance |
0.99 (0.91–1.07) |
0.77 |
Time of day patient presented to the emergency department |
||
00:00–07:59 |
0.89 (0.81–0.98) |
0.01 |
16:00–23:59 |
0.93 (0.86–1.00) |
0.05 |
Day of week patient presented to the emergency department, weekend |
0.94 (0.87–1.03) |
0.17 |
Emergency department physician, age per decade increase |
0.97 (0.84–1.12) |
0.62 |
Emergency department physician, female |
1.06 (0.93–1. 20) |
0.34 |
Emergency department physician, main specialty; referent = family medicine training |
||
Emergency medicine (3-yr program) |
0.90 (0.76–1.05) |
0.16 |
Emergency medicine (5-yr program) |
0.91 (0.75–1.10) |
0.29 |
Other |
0.93 (0.57–1.53) |
0.73 |
Emergency department physician, no. of years of practice; yr |
||
4–10 |
1.03 (0.91–1.16) |
0.38 |
11–20 |
0.98 (0.83–1.15) |
0.85 |
> 20 |
0.98 (0.73–1.30) |
0.86 |
Hospital type; referent = community |
||
Small |
0.82 (0.69–0.98) |
0.03 |
Teaching |
1.16 (1.04–1.29) |
0.007 |
Family physician characteristics |
||
Family physician, age per decade increase |
1.00 (0.99–1.00) |
0.24 |
Family physician, female |
0.99 (0.91–1.07) |
0.82 |
Family physician, no. of years of practice; yr |
||
6–10 |
1.02 (0.82–1.27) |
0.83 |
11–15 |
1.07 (0.87–1.31) |
0.54 |
> 15 |
1.06 (0.86–1.29) |
0.59 |
Family physician, reimbursement type |
||
CCM* or FHG†; referent |
||
FHN‡ with FHT |
0.73 (0.62–0.86) |
< 0.001 |
FHN‡ without FHT |
0.77 (0.60–0.97) |
0.03 |
FHO§ with FHT |
0.84 (0.76–0.93) |
< 0.001 |
FHO§ without FHT |
0.86 (0.79–0.94) |
0.001 |
FFS¶ | 0.94 (0.82–1.07) | 0.33 |
Note: ADG = aggregated diagnosis group, CCM = comprehensive care model, CHADS2 = cardiac failure, hypertension, age, diabetes, stroke system, CI = confidence interval, FFS = fee for service, FHG = family health group, FHN = family health network, FHO = family health organization, FHT = family health team, OR = odds ratio, SD = standard deviation. *Primarily fee for service, < 3 physicians. †Primarily fee for service, ≥ 3 physicians. ‡Primarily capitation, small basket of services. §Primarily capitation, large basket of services. ¶Traditional fee for service.