Table 2.
Control Function Regressions
| First‐Stage Equation | Second‐Stage Equation | ||||
|---|---|---|---|---|---|
| Nursing Only | Physician Only | Both | Rehospitalized | Hospice or Death | |
| Instruments | |||||
| Index hospital rate of early follow‐up among non‐HF medical patients | |||||
| Intensive home health nursing only | 1.051 (0.002)*** | 1.000 (0.002) | 1.047 (0.003)*** | ||
| Physician visit only | 1.002 (0.003) | 1.041 (0.002)*** | 1.038 (0.003)*** | ||
| Both treatments | 1.048 (0.003)*** | 1.043 (0.003)*** | 1.101 (0.004)*** | ||
| Index stay discharge date | |||||
| Friday | 1.182 (0.029)*** | 1.163 (0.026)*** | 1.601 (0.044)*** | ||
| Saturday or Sunday | 0.557 (0.015)*** | 0.951 (0.021)* | 0.574 (0.020)*** | ||
| Exposure categories | |||||
| Nursing treatment only | 0.973 (0.181) | 1.708 (0.730) | |||
| Physician treatment only | 0.964 (0.212) | 1.477 (0.852) | |||
| Both treatments | 0.553 (0.096)*** | 0.329 (0.146)** | |||
| Residuals | |||||
| Residuals from first stage: nursing only | 1.075 (0.201) | 0.650 (0.280) | |||
| Residuals from first stage: physician only | 1.061 (0.234) | 0.613 (0.356) | |||
| Residuals from first stage: both treatments | 1.955 (0.343)*** | 3.233 (1.448)** | |||
| Sociodemographics | |||||
| Age | |||||
| <65 | 0.935 (0.037) | 0.894 (0.033)** | 0.808 (0.043)*** | 1.125 (0.038)*** | 1.062 (0.128) |
| 75–84 | 1.107 (0.029)*** | 1.051 (0.026)* | 1.030 (0.033) | 0.834 (0.019)*** | 0.946 (0.066) |
| 85+ | 1.132 (0.032)*** | 0.952 (0.025) | 0.948 (0.033) | 0.763 (0.020)*** | 1.499 (0.104)*** |
| Race–ethnicity | |||||
| Hispanic | 0.867 (0.039)** | 1.005 (0.042) | 0.897 (0.052) | 0.980 (0.036) | 0.497 (0.065)*** |
| Non‐Hispanic blacks | 0.775 (0.024)*** | 0.818 (0.023)*** | 0.713 (0.028)*** | 1.026 (0.028) | 0.557 (0.046)*** |
| Female | 0.935 (0.017)*** | 0.923 (0.016)*** | 0.882 (0.020)*** | 0.920 (0.016)*** | 0.680 (0.030)*** |
| Median household income (in $5,000s) | 1.006 (0.003)* | 1.014 (0.002)*** | 1.017 (0.004)*** | 0.995 (0.002)* | 1.012 (0.006)* |
| Index stay admission via ER | 0.942 (0.021)** | 0.966 (0.021) | 0.926 (0.027)** | 1.073 (0.022)*** | 1.015 (0.053) |
| Recent medical history | |||||
| Heart failure (not a new HF patient) | 0.975 (0.020) | 1.026 (0.020) | 0.975 (0.025) | 1.405 (0.029)*** | 1.449 (0.077)*** |
| Atrial fibrillation | 1.088 (0.020)*** | 1.151 (0.020)*** | 1.218 (0.028)*** | 1.178 (0.020)*** | 1.004 (0.046) |
| Acute myocardial infarction | 1.022 (0.033) | 0.986 (0.031) | 1.077 (0.044) | 1.265 (0.035)*** | 1.049 (0.081) |
| Coronary artery bypass graft | 1.145 (0.073)* | 1.240 (0.071)*** | 1.238 (0.092)** | 0.786 (0.045)*** | 0.400 (0.100)*** |
| Stroke/transient ischemic attack | 1.006 (0.028) | 1.116 (0.030)*** | 1.069 (0.038) | 1.055 (0.026)* | 0.963 (0.064) |
| Peripheral vascular disease | 1.068 (0.024)** | 1.083 (0.022)*** | 1.150 (0.032)*** | 1.137 (0.022)*** | 1.115 (0.059)* |
| Metastatic cancer | 1.069 (0.058) | 1.266 (0.061)*** | 1.217 (0.078)** | 1.203 (0.054)*** | 1.383 (0.147)** |
| Chronic condition warehouse indicator | |||||
| Alzheimer's disease or related disorder | 0.915 (0.020)*** | 0.881 (0.019)*** | 0.841 (0.025)*** | 1.226 (0.024)*** | 0.968 (0.050) |
| Depression | 0.957 (0.019)* | 1.051 (0.020)** | 1.016 (0.026) | 1.254 (0.023)*** | 0.819 (0.042)*** |
| Index stay MS‐DRG | |||||
| 280–282 (acute MI) | 1.148 (0.081)* | 1.005 (0.071) | 1.073 (0.097) | 1.036 (0.066) | 1.159 (0.174) |
| 286–287 (HF w/cardiac catheterization) | 1.136 (0.056)** | 1.041 (0.051) | 1.297 (0.075)*** | 1.022 (0.045) | 0.624 (0.106)** |
| 292 (HF CC) | 0.978 (0.021) | 0.964 (0.020) | 0.948 (0.024)* | 0.971 (0.018) | 0.936 (0.047) |
| 293 (HF no CC) | 0.899 (0.023)*** | 0.964 (0.024) | 0.856 (0.027)*** | 0.873 (0.021)*** | 0.806 (0.055)** |
| Index stay comorbidities | |||||
| Metastatic cancer | 1.067 (0.115) | 1.496 (0.142)*** | 1.328 (0.164)* | 1.436 (0.124)*** | 2.540 (0.443)*** |
| Lymphoma | 1.067 (0.102) | 1.587 (0.131)*** | 1.321 (0.143)** | 1.163 (0.094) | 1.318 (0.256) |
| Solid tumor without metastasis | 1.005 (0.073) | 1.153 (0.078)* | 1.086 (0.096) | 1.243 (0.077)*** | 2.002 (0.251)*** |
| Diabetes | 1.036 (0.020) | 1.044 (0.019)* | 1.009 (0.025) | 1.010 (0.018) | 0.765 (0.039)*** |
| Fluid and electrolyte disorders | 1.061 (0.023)** | 1.065 (0.022)** | 1.105 (0.029)*** | 1.083 (0.021)*** | 1.197 (0.062)*** |
| Obesity | 1.044 (0.035) | 0.924 (0.031)* | 0.930 (0.041) | 0.785 (0.026)*** | 0.602 (0.067)*** |
| Deficiency anemia | 1.007 (0.024) | 1.050 (0.023)* | 1.012 (0.029) | 1.047 (0.022)* | 1.010 (0.056) |
| Coagulopathy | 1.077 (0.058) | 1.054 (0.054) | 1.235 (0.076)*** | 1.152 (0.052)** | 1.192 (0.150) |
| Paralysis | 0.947 (0.061) | 0.864 (0.060)* | 0.749 (0.068)*** | 0.840 (0.053)** | 0.666 (0.105)** |
| Other neurological disorders | 0.906 (0.036)** | 0.966 (0.039) | 0.924 (0.050) | 0.904 (0.035)** | 0.803 (0.078)* |
| Hypertension | 0.977 (0.018) | 1.018 (0.017) | 0.994 (0.022) | 0.945 (0.016)*** | 0.842 (0.037)*** |
| Chronic pulmonary disease | 0.942 (0.018)** | 0.968 (0.018) | 0.928 (0.023)** | 1.061 (0.019)*** | 0.907 (0.043)* |
| Liver disease | 0.930 (0.084) | 1.045 (0.081) | 0.809 (0.089)* | 1.324 (0.093)*** | 1.060 (0.240) |
| Renal failure | 0.997 (0.020) | 1.034 (0.020) | 1.055 (0.027)* | 1.205 (0.022)*** | 1.325 (0.064)*** |
| Weight loss | 1.093 (0.058) | 0.987 (0.054) | 0.984 (0.066) | 1.105 (0.054)* | 1.223 (0.128)* |
| Index stay days in ICU | |||||
| 1–2 days in ICU | 0.972 (0.029) | 1.060 (0.029)* | 0.995 (0.038) | 0.979 (0.025) | 1.031 (0.071) |
| 3–4 days in ICU | 1.012 (0.028) | 1.028 (0.025) | 1.016 (0.035) | 1.003 (0.023) | 1.011 (0.064) |
| 5–6 days in ICU | 1.111 (0.037)*** | 1.006 (0.032) | 1.090 (0.044)* | 1.058 (0.030)* | 1.009 (0.079) |
| 7+ days in ICU | 1.213 (0.043)*** | 0.970 (0.033) | 1.156 (0.050)*** | 1.131 (0.033)*** | 0.951 (0.075) |
| Number of index stay diagnostic procedures | |||||
| 1 Procedure | 1.038 (0.027) | 1.027 (0.026) | 1.037 (0.034) | 1.070 (0.026)** | 0.987 (0.061) |
| 2+ Procedures | 1.070 (0.072) | 0.96 (0.062) | 1.084 (0.086) | 1.216 (0.068)*** | 1.074 (0.153) |
| OASIS: resumption of care | 0.942 (0.019)** | 0.963 (0.018)* | 0.976 (0.024) | 1.129 (0.020)*** | 1.144 (0.054)** |
| Frequency of dyspnea | |||||
| At rest (during day or night) | 1.189 (0.047)*** | 1.000 (0.039) | 1.186 (0.059)*** | 1.367 (0.046)*** | 1.537 (0.131)*** |
| With minimal exertion | 1.161 (0.031)*** | 1.005 (0.025) | 1.164 (0.039)*** | 1.193 (0.028)*** | 1.281 (0.087)*** |
| With moderate exertion | 1.066 (0.025)** | 1.008 (0.022) | 1.099 (0.032)*** | 1.063 (0.022)** | 1.027 (0.065) |
| Receiving oxygen in home | 1.082 (0.021)*** | 0.929 (0.018)*** | 0.977 (0.025) | 1.121 (0.021)*** | 1.413 (0.066)*** |
| Sum of ADLs and IADLs (range 0–8) | |||||
| 1 | 1.121 (0.046)** | 1.052 (0.040) | 1.155 (0.057)** | 1.031 (0.039) | 1.184 (0.198) |
| 2 | 1.147 (0.048)*** | 1.050 (0.040) | 1.182 (0.059)*** | 1.022 (0.038) | 1.538 (0.246)** |
| 3 | 1.122 (0.049)** | 1.024 (0.042) | 1.200 (0.063)*** | 1.082 (0.042)* | 1.987 (0.316)*** |
| 4 | 1.206 (0.055)*** | 1.044 (0.044) | 1.243 (0.068)*** | 1.126 (0.046)** | 2.012 (0.330)*** |
| 5 | 1.284 (0.063)*** | 0.980 (0.044) | 1.218 (0.071)*** | 1.121 (0.049)** | 2.540 (0.414)*** |
| 6 | 1.361 (0.071)*** | 0.902 (0.046)* | 1.222 (0.079)** | 1.107 (0.052)* | 3.154 (0.524)*** |
| 7+ | 1.491 (0.102)*** | 0.812 (0.058)** | 0.995 (0.091) | 1.189 (0.075)** | 4.793 (0.893)*** |
| Mobility | |||||
| Some impairment | 0.934 (0.036) | 0.847 (0.030)*** | 0.772 (0.033)*** | 1.048 (0.038) | 1.192 (0.173) |
| Chair/bedfast | 1.077 (0.065) | 0.587 (0.039)*** | 0.620 (0.049)*** | 1.221 (0.070)*** | 1.990 (0.333)*** |
| Dressing—Human help required with upper and lower body dressing | 1.011 (0.028) | 0.968 (0.025) | 1.025 (0.034) | 1.122 (0.027)*** | 1.475 (0.099)*** |
| Cognitive function | |||||
| Needs infrequent prompting | 0.991 (0.021) | 0.957 (0.020)* | 0.937 (0.024)** | 1.023 (0.020) | 1.060 (0.057) |
| Needs more active direction | 0.989 (0.036) | 0.913 (0.033)** | 0.910 (0.042)* | 0.919 (0.030)** | 1.266 (0.095)** |
| Needs considerable direction | 0.925 (0.059) | 0.850 (0.057)* | 0.921 (0.076) | 0.870 (0.050)* | 1.484 (0.157)*** |
| Anxious | |||||
| Less often than daily | 1.012 (0.022) | 0.985 (0.020) | 1.000 (0.027) | 1.036 (0.020) | 1.029 (0.053) |
| Daily, but not constantly | 1.021 (0.027) | 0.969 (0.025) | 0.989 (0.033) | 1.082 (0.024)*** | 1.088 (0.065) |
| All of the time | 1.073 (0.090) | 0.977 (0.086) | 1.213 (0.123)* | 1.211 (0.087)** | 1.470 (0.244)* |
| Disruptive behavior | 1.001 (0.026) | 1.003 (0.025) | 0.990 (0.031) | 0.947 (0.021)** | 0.907 (0.051) |
| N = 98,730 | N = 98,730 | ||||
ADL, activities of daily living; CC, complications or comorbidities; ER, emergency room; HF, heart failure; HF w/ cardiac, heart failure with cardiac catheterization; IADL, instrumental activities of daily living; ICU, intensive care unit; MCC,major complications or comorbidities; MI, myocardial infarction; MS‐DRG, Medicare Severity Diagnosis Related Group; OASIS, Outcome and Assessment Information Set.
Cluster‐robust (home health agency level) standard errors are in parentheses. Thirty‐day outcome reference category is “no event” during the follow‐up period. Control function adjustment for endogenous treatment. State‐level dummy variables omitted from table.
*p ≤ .05, **p ≤ .01, ***p ≤ .001.