Table 4.
Multivariate analysis - Insurance status as a predictor of non-referral for lung transplant evaluation, adjusted for all covariates listed in the table
| Models
| ||
|---|---|---|
| Primary SES Indicator | OR (95% CI) | P Value |
|
| ||
| Medicaid | 1.79 (1.29, 2.47) | <0.001 |
| No Medicaid | REF | |
| Demographics | ||
| Age (per 5 year increase) | 1.25 (1.13, 1.39) | <0.001 |
| Male gender | 1.19 (0.86, 1.65) | 0.291 |
| Race, white vs. non-white | 0.85 (0.44, 1.66) | 0.640 |
| Not a high school graduate | 2.27 (1.42, 3.64) | 0.001 |
| Disease Severity | ||
| FEV1 % predicted | 1.01 (0.97, 1.06) | 0.652 |
| # Acute Exacerbations | 0.93 (0.87, 0.99) | 0.031 |
| Supplemental oxygen | 0.59 (0.43, 0.81) | 0.001 |
| BMI | 0.95 (0.90, 1.00) | 0.067 |
| CF-related diabetes on insulin | 0.87 (0.62, 1.20) | 0.390 |
| Potential Contraindications | ||
| Positive sputum culture: | ||
| Burkholderia cepacia complex | 2.48 (1.50, 4.12) | <0.001 |
| Nontuberculous mycobacterium | 0.69 (0.18, 2.64) | 0.590 |
| CF-related liver cirrhosis | 0.80 (0.39, 1.64) | 0.538 |
| Renal failure requiring dialysis | 0.24 (0.04, 1.38) | 0.111 |
| Osteoporosis | 0.78 (0.51, 1.20) | 0.257 |
| Cancer, tissue proven | 1.02 (0.08, 13.82) | 0.987 |
| Depression | 1.41 (0.98, 2.03) | 0.065 |
| No marital partner | 1.36 (1.00, 1.87) | 0.053 |
| <4 outpatient visits per year | 1.33 (0.90, 1.95) | 0.152 |
| Driving time to Lung Transplant Center | ||
| <30 min (1st quartile) | REF | |
| 30–75 min (2nd quartile) | 0.96 (0.60, 1.54) | 0.878 |
| 75–150 min (3rd quartile) | 0.99 (0.65, 1.50) | 0.947 |
| >150 min (4th quartile) | 1.23 (0.81, 1.86) | 0.343 |
| Period of Lung Transplant | ||
| Pre-LAS (<2005) | 0.87 (0.65, 1.16) | 0.332 |
All models adjusted for cluster effects at the level of the CF care center
OR = odds ratio, SES = socioeconomic status, FEV1 = forced expiratory volume in 1 second, BMI = body mass index, CF = cystic fibrosis, min = minutes, LAS = lung allocation score