Table 4.
Patient LevelPredictors of CDS Use, Multivariate Models (N=2550)
| OR* (95% CI) | p-value | OR** (95% CI) | p-value | |
|---|---|---|---|---|
|
| ||||
| Age | 0.99 (0.98, 1.003) | 0.20 | 1.00 (0.99, 1.004) | 0.30 |
|
| ||||
| Female gender | 1.06 (0.88, 1.28) | 0.51 | 1.07 (0.91, 1.27) | 0.40 |
|
| ||||
| Race (vs. White) | ||||
| Black, non-Hispanic | 0.53 (0.40, 0.69) | <0.001 | 0.65 (0.49, 0.88) | 0.01 |
| Hispanic | 1.00 (0.72, 1.39) | 0.98 | 0.99 (0.70, 1.33) | 0.84 |
| Other | 1.31 (0.85, 2.04) | 0.21 | 1.24 (0.80, 1.91) | 0.34 |
|
| ||||
| Payer (vs. Medicare only) | ||||
| Private | 0.69 (0.50, 0.94) | 0.01 | 0.68 (0.53, 0.87) | 0.003 |
| Dually Eligible | 1.02 (0.76, 1.36) | 0.91 | 1.00 (0.79, 1.29) | 0.97 |
| Medicaid only | 0.66 (0.51, 0.87) | 0.003 | 0.73 (0.57, 0.92) | 0.01 |
| Other | 0.52 (0.28, 0.96) | 0.04 | 0.65 (0.37, 1.14) | 0.13 |
|
| ||||
| Language (vs. English-blank) | ||||
| Spanish | 0.95 (0.69, 1.31) | 0.76 | 0.88 (0.66, 1.18) | 0.39 |
| Other | 1.25 (0.84, 1.87) | 0.27 | 0.88 (0.61, 1.28) | 0.51 |
|
| ||||
| Number of medications | 1.02 (0.99, 1.05) | 0.20 | 1.02 (1.00, 1.05) | 0.06 |
|
| ||||
| Discharged from acute hospital within 14 days of home care admission? | 1.06 (0.87, 1.29) | 0.54 | 1.11 (0.94, 1.31) | 0.21 |
|
| ||||
| Discharged from inpatient rehabilitation hospital or unit within 14 days of home care admission? | 1.23 (0.92, 1.63) | 0.16 | 1.24 (0.96, 1.60) | 0.10 |
|
| ||||
| AIDS | 0.76 (0.26, 2.20) | 0.61 | 0.97 (0.43, 2.20) | 0.95 |
|
| ||||
| Cancer | 0.77 (0.55, 1.08) | 0.13 | 0.78 (0.59, 1.01) | 0.06 |
|
| ||||
| Hypertension | 1.21 (0.96, 1.52) | 0.11 | 1.22 (0.95, 1.56) | 0.12 |
|
| ||||
| Cardiac Condition | 1.48 (1.10, 1.98) | 0.01 | 1.43 (1.10, 1.86) | 0.01 |
|
| ||||
| Stroke | 1.53 (1.07, 2.19) | 0.02 | 1.49 (1.08, 2.05) | 0.01 |
|
| ||||
| History of falls (2 or more falls - or any fall with an injury - in the past year | 1.11 (0.86, 1.44) | 0.40 | 1.03 (0.81, 1.30) | 0.83 |
|
| ||||
| The patient is stable with no heightened risk(s) for serious complications and death (beyond those typical of the patient’s age). | 0.89 (0.67, 1.20) | 0.46 | 1.09 (0.83, 1.44) | 0.55 |
|
| ||||
| The patient is temporarily facing high health risk(s) but is likely to return to being stable without heightened risk(s) for serious complications and death (beyond those typical of the patient’s age) - OR patient’s situation is unknown or unclear | 1.04 (0.82, 1.32) | 0.74 | 1.08 (0.89, 1.30) | 0.44 |
|
| ||||
| Cognitive function | 1.06 (0.83, 1.34) | 0.66 | 1.00 (0.84, 1.19) | 0.99 |
|
| ||||
| Ever short of breath | 1.23 (1.02, 1.47) | 0.03 | 1.22 (1.04, 1.42) | 0.01 |
|
| ||||
| Human assistance needed with oral medications | 1.11 (0.90, 1.36) | 0.32 | 0.96 (0.82, 1.13) | 0.65 |
|
| ||||
| Number of nurse visits | 1.03 (1.01, 1.04) | <0.001 | 1.01 (1.003, 1.02) | 0.01 |
|
| ||||
| Index COC changed | 0.66 (0.53, 0.82) | <0.001 | 0.71 (0.56, 0.90) | 0.004 |
|
| ||||
| Sum of Chronic Conditions | 0.91 (0.83, 0.99) | 0.03 | 0.92 (0.86, 0.98) | 0.01 |
|
| ||||
| Sum of ADL/IADL dependencies | 0.94 (0.89, 0.99) | 0.04 | 0.97 (0.93. 1.02) | 0.22 |
|
| ||||
| Length of stay | 1.02 (1.01, 1.03) | <0.001 | 1.03 (1.02, 1.03) | <0.001 |
*
Not adjusted for nurse clustering
**
Adjusted for nurse clustering at the Coordinator of Care level
CDS = clinical decision support; OR = odds ratio; CI = Confidence Interval; COC = Nurse coordinator of care (nurse in charge of case); ADL/IADL = activities of daily living/instrumental activities of daily living