Table 1.
Patient-level predictors of new institutionalization
| N (%) | Observed Rates | Odds Ratioa (95% CI) | |
|---|---|---|---|
| All | 4,824,040 | 3.6% | |
| Age (years) | |||
| 66 – 70 | 1,088,294 (22.6) | 1.4% | Reference |
| 71 – 75 | 1,019,135 (21.1) | 2.0% | 1.42 (1.38, 1.46) |
| 76 – 80 | 941,903 (19.5) | 3.0% | 2.00 (1.94, 2.05) |
| 81 – 85 | 855,966 (17.7) | 4.6% | 2.95 (2.87, 3.03) |
| 86 – 90 | 607,622 (12.6) | 6.7% | 4.25 (4.13, 4.36) |
| ≥91 | 311,120 (6.5) | 9.9% | 6.57 (6.38, 6.76) |
| Sex | |||
| Female | 2,786,145 (57.8) | 4.3% | Reference |
| Male | 2,037,895 (42.2) | 2.7% | 0.98 (0.96, 0.99) |
| Race/Ethnicity | |||
| White | 4,058,115 (84.1) | 3.6% | Reference |
| Black | 389,400 (8.1) | 4.5% | 0.79 (0.77, 0.81) |
| Hispanic | 228,961 (4.8) | 3.3% | 0.56 (0.54, 0.58) |
| Others | 147,564 (3.1) | 3.3% | 0.68 (0.65, 0.71) |
| Medicaid eligibility | |||
| No | 4,020,084 (83.3) | 2.5% | Reference |
| Yes | 803,956 (16.7) | 9.3% | 4.35 (4.29, 4.42) |
| Income quartileb | |||
| <40,696 | 1,205,843 (25.0) | 4.1% | Reference |
| 40,696 – 50,810 | 1,205,851 (25.0) | 3.8% | 1.06 (1.03, 1.08) |
| 50,810 – 66,898 | 1,206,331 (25.0) | 3.4% | 1.07 (1.04, 1.09) |
| >66,898 | 1,206,015 (25.0) | 3.1% | 1.09 (1.07, 1.12) |
| SNF prior 6 monthsc | |||
| No | 4,382,120 (90.8) | 2.5% | Reference |
| Yes | 441,920 (9.2) | 14.2% | 4.51 (4.44, 4.58) |
| Type of DRG | |||
| Medical | 3,298,379 (68.4) | 4.4% | Reference |
| Surgical | 1,525,661 (31.6) | 1.8% | 0.55 (0.54, 0.56) |
| Length of hospital stayd | |||
| Quartile 1 | 1,693,688 (35.1) | 1.5% | Reference |
| Quartile 2 | 1,258,153 (26.1) | 3.7% | 2.05 (2.01, 2.09) |
| Quartile 3 | 886,713 (18.4) | 4.7% | 2.38 (2.33, 2.44) |
| Quartile 4 | 985,486 (20.4) | 6.1% | 3.05 (2.99, 3.11) |
| ICUe | |||
| No | 3,598,522 (74.6) | 3.6% | Reference |
| Yes | 1,225,518 (25.4) | 3.5% | 0.95 (0.94, 0.97) |
Abbreviations: SNF, skilled nursing facility; DRG, diagnostic-related group; ICU, intensive care unit
Odds ratios are from a multilevel model adjusted for all characteristics presented in the table, as well as patients’ comorbidities and diagnostic group (DRG_MDC) (Supplementary Table S1) and hospital state.
Income level at the beneficiary’s zip code of residence obtained from the 2013 American Community Survey (ACS) estimates of the U.S. Census Bureau.
Received care in a skilled nursing facility in the six months prior to hospitalization.
Length of stay quartiles based on expected length of stay for the admitting diagnosis-related group major diagnostic category (DRG-MDC).
Admitted to ICU during index hospitalization.