Table 4.
Determinants of Rural Women Giving Birth in a Non-Local Hospital (N=216,076)
| Adjusted Odds Ratio (95% Confidence Interval) | Average Marginal Effects (%) | P-value | |
|---|---|---|---|
| MATERNAL CLINICAL CONDITION | |||
| Conditions Which May Require Maternal Fetal Medicine Services or Consultation | 1.28 (1.22, 1.35) | 4.5% | <.001 |
| Malposition, Malpresentation | 1.16 (1.08, 1.24) | 2.7% | <.001 |
| Multiple Gestation | 1.82 (1.58, 2.1) | 12.3% | <.001 |
| Pregnancy Delivered Before 37 Weeks Gestation | 2.41 (2.17, 2.67) | 18.7% | <.001 |
| Previous Cesarean Section | 1.25 (1.17, 1.34) | 4.2% | <.001 |
| MATERNAL CHARACTERISTICS | |||
| Age | |||
| Age ≤20 | 0.82 (0.74, 0.9) | −3.5% | <.001 |
| 21≤Age≤25 | 0.91 (0.86, 0.97) | −1.6% | <.001 |
| 26≤Age≤30 | Ref | - | - |
| 31≤Age≤35 | 1.04 (1.01, 1.07) | 0.8% | <.001 |
| Age≥36 | 1.12 (1.04, 1.21) | 2.2% | <.001 |
| Primary Payer | |||
| Medicaid | 0.76 (0.68, 0.86) | −4.9% | <.001 |
| Private | Ref | - | - |
| Self | 0.96 (0.77, 1.18) | −0.8% | 0.681 |
| Other | 0.91 (0.82, 1.02) | −1.8% | 0.093 |
| Race/Ethnicity | |||
| White | Ref | - | - |
| Black | 0.67 (0.60, 0.76) | −6.5% | <.001 |
| Hispanic | 0.70 (0.56, 0.88) | −5.9% | <.001 |
| Native American, Asian, Other | 1.14 (0.84, 1.57) | 2.6% | 0.401 |
| Patient Residence Rurality | |||
| Micropolitan area | Ref | - | - |
| Noncore adjacent to a metro area | 2.29 (1.77, 2.96) | 15.9% | <.001 |
| Noncore not adjacent to a metro area | 1.88 (1.13, 3.16) | 11.6% | 0.016 |
| LOCAL HOSPITAL CHARACTERISTICS | |||
| Neonatal Care Capacity | |||
| Any Neonatal Intensive Care Units | Ref | - | - |
| Neonatal Intermediate Care Units Only | 1.77 (1.25, 2.51) | 9.4% | <.001 |
| No NICU or NINT | 1.94 (1.64, 2.31) | 11.3% | <.001 |
| Local Hospital(s) with: | |||
| Accreditation | 0.92 (0.67, 1.26) | −1.5% | 0.602 |
| System Affiliation | 1.02 (0.81, 1.3) | 0.4% | 0.859 |
Note: Model also controlled for year of birth and maternal residence of state. Average marginal effects demonstrate a change in the predicted probability of non-local delivery for an average rural woman in one category relative to the referents.