Table 3.
Adjusted Association of Controlled Medication with Sociodemographic Clinical and Organizational Factors
| Any Med | Opiate | Benzodiazepine | Hypnotic | |||||
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | |
| Age, years (Reference: 65–74 years) | ||||||||
| 75 – 84 | 0.65 | (0.62, 0.67) | 0.63 | (0.61, 0.66) | 0.77 | (0.74, 0.80) | 0.74 | (0.70, 0.79) |
| 85+ | 0.42 | (0.41, 0.44) | 0.41 | (0.40, 0.43) | 0.56 | (0.53, 0.58) | 0.52 | (0.48, 0.56) |
| Female | 1.47 | (1.43, 1.52) | 1.26 | (1.22, 1.30) | 1.57 | (1.51, 1.63) | 1.29 | (1.22, 1.37) |
| Race (Reference: White) | ||||||||
| Black | 0.61 | (0.58, 0.64) | 0.81 | (0.77, 0.85) | 0.44 | (0.41, 0.47) | 0.54 | (0.49, 0.60) |
| Asian | 0.52 | (0.44, 0.62) | 0.66 | (0.55, 0.79) | 0.35 | (0.26, 0.47) | 0.67 | (0.47, 0.96) |
| Other | 0.66 | (0.55, 0.80) | 0.76 | (0.62, 0.92) | 0.59 | (0.46, 0.75) | 0.54 | (0.37, 0.81) |
| Hispanic | 0.82 | (0.74, 0.92) | 0.86 | (0.77, 0.96) | 0.68 | (0.59, 0.78) | 0.82 | (0.67, 1.00) |
| Dual Eligible | 1.13 | (1.04, 1.23) | 1.06 | (0.97, 1.15) | 1.22 | (1.11, 1.34) | 1.43 | (1.25, 1.64) |
| Referral Source (Reference: Community) | ||||||||
| Hospital | 1.39 | (1.34, 1.44) | 1.65 | (1.59, 1.72) | 1.02 | (0.98, 1.07) | 1.07 | (1.00, 1.14) |
| SNF/Rehab | 1.38 | (1.33, 1.44) | 1.62 | (1.56, 1.69) | 1.09 | (1.04, 1.14) | 1.27 | (1.18, 1.37) |
| Primary Diagnoses | ||||||||
| Heart Failure | 0.72 | (0.68, 0.76) | 0.64 | (0.60, 0.68) | 1.04 | (0.97, 1.11) | 1.09 | (0.98, 1.21) |
| Stroke | 0.57 | (0.52, 0.61) | 0.45 | (0.41, 0.49) | 0.84 | (0.76, 0.93) | 0.89 | (0.76, 1.04) |
| Osteoarthritis | 1.24 | (1.11, 1.38) | 1.35 | (1.22, 1.51) | 0.88 | (0.77, 1.00) | 0.93 | (0.76, 1.15) |
| Type II diabetes | 0.64 | (0.58, 0.70) | 0.61 | (0.55, 0.67) | 0.84 | (0.74, 0.95) | 1.13 | (0.95, 1.35) |
| Rehabilitation: fracture | 1.45 | (1.33, 1.59) | 2.07 | (1.90, 2.26) | 0.82 | (0.74, 0.91) | 0.86 | (0.73, 1.01) |
| Surgery aftercare | 2.54 | (2.41, 2.69) | 3.41 | (3.24, 3.59) | 0.61 | (0.57, 0.65) | 0.91 | (0.83, 0.99) |
| ADL limitations | 1.15 | (1.13, 1.17) | 1.14 | (1.12, 1.16) | 1.08 | (1.06, 1.10) | 1.03 | (1.00, 1.06) |
| PHQ-2 > 3 | 1.33 | (1.23, 1.43) | 1.01 | (0.93, 1.08) | 1.95 | (1.81, 2.11) | 1.71 | (1.53, 1.90) |
| Poor cognitive function | 0.73 | (0.70, 0.76) | 0.59 | (0.56, 0.61) | 1.11 | (1.05, 1.16) | 0.91 | (0.84, 0.99) |
| Severe pain | 2.44 | (2.35, 2.53) | 3.04 | (2.93, 3.14) | 1.28 | (1.23, 1.33) | 1.33 | (1.25, 1.40) |
| Obesity | 1.12 | (1.08, 1.17) | 1.16 | (1.11, 1.20) | 0.89 | (0.85, 0.94) | 1.04 | (0.97, 1.12) |
| Region (Reference: Northeast) | ||||||||
| Midwest | 1.40 | (1.35, 1.46) | 1.65 | (1.58, 1.72) | 0.98 | (0.93, 1.03) | 1.23 | (1.13, 1.33) |
| South | 1.65 | (1.58, 1.72) | 1.76 | (1.68, 1.84) | 1.32 | (1.25, 1.39) | 1.57 | (1.45, 1.70) |
| West | 1.63 | (1.49, 1.78) | 2.2 | (2.01, 2.41) | 0.95 | (0.85, 1.06) | 1.76 | (1.52, 2.04) |
| Agency Ownership (Reference: Private For-Profit) | ||||||||
| Religious Non-Profit | 1.18 | (1.05, 1.31) | 1.24 | (1.11, 1.38) | 0.86 | (0.75, 0.98) | 1.16 | (0.97, 1.40) |
| Private Non-Profit | 1.04 | (0.99, 1.08) | 1.06 | (1.01, 1.10) | 1.09 | (1.04, 1.14) | 1.03 | (0.96, 1.12) |
| Public | 1.21 | (1.14, 1.28) | 1.19 | (1.13, 1.27) | 1.21 | (1.13, 1.29) | 1.01 | (0.92, 1.12) |
| Rural | 1.12 | (1.07, 1.17) | 1.14 | (1.09, 1.19) | 1.02 | (0.97, 1.07) | 1.03 | (0.95, 1.11) |
Notes: BNZ – Benzodiazepine; Any med – Any prescription for an opioid, benzodiazepine or hypnotic; SNF – Skilled Nursing Facility; ADL – Activities of Daily Living; PHQ – Patient Health Questionnaire