Table 2.

Results of random effects logistic regression of transfer to any tertiary care hospital

Variable	Odds ratio	p-value	Lower limit 95% CI	Upper limit 95% CI
Patient age 65 and over	0.69	0.06	0.48	1.01
Chronic obstructive pulmonary disease	0.48	<0.001	0.31	0.74
Bleeding disorder	0.68	0.04	0.47	0.98
Smoker	3.28	0.01	1.32	8.12
Prior percutaneous coronary intervention	1.30	0.18	0.89	1.91
Chronic heart failure	2.10	<0.001	1.33	3.32
ST segment elevation on presenting electrocardiogram	2.07	<0.001	1.32	3.26
Cardiac enzymes abnormal on presentation	0.92	0.65	0.64	1.31
Do not resuscitate during hospitalization	0.29	<0.001	0.12	0.65
In-hospital event*	3.14	<0.001	2.21	4.46
Distance from patient home zip code centroid to hospital >100 miles	1.71	0.02	1.08	2.70
Distance from primary VHA to tertiary VHA hospital in miles	0.998	0.03	0.997	0.999
Degree of market competition (1 = not competitive; 3 = highly competitive)	0.55	<0.001	0.41	0.73
VHA cardiologist on site	0.48	<0.001	0.29	0.79
Tertiary VHA hospital has referral coordinator	0.39	<0.001	0.23	0.69
Primary VHA hospital has referral coordinator	6.53	<0.001	3.29	12.98

* Presence of at least one of the following adverse events during admission: angina persisting more than 24 hours after admission; a hypotensive episode; an episode of heart failure; cardiac arrest; or positive stress test during admission