Table 3.
Logistic regression analysis of RAI persistence during the 12-month follow-up period among patients with T2D who added RAI to their basal insulin regimen.
| Characteristic | Adjusted OR (95% CI) | p-value |
|---|---|---|
| All (N = 3,927)* | ||
|
| ||
| Gender | ||
| Female | 1.05 (0.89–1.23) | 0.558 |
| Male | Ref. | |
| Race | ||
| African American | 0.78 (0.61–1.01) | 0.058 |
| Other | 0.87 (0.60–1.27) | 0.477 |
| White | Ref. | |
| Age group, years | ||
| ≥75 | 1.20 (1.01–1.43) | 0.037 |
| 65–74 | Ref. | |
| United States region | ||
| Midwest | 0.99 (0.77–1.28) | 0.955 |
| South | 0.89 (0.70–1.13) | 0.325 |
| Northeast, west, other | Ref. | |
| Type of Medicare plan | ||
| HMO | 1.10 (0.89–1.36) | 0.362 |
| PPO, other | 0.71 (0.57–0.88) | 0.002 |
| PFFS | Ref. | |
| Clinical characteristics | ||
| Any hypoglycemia | ||
| Yes | 0.96 (0.74–1.24) | 0.740 |
| No | Ref. | |
| aDCSI score | ||
| 0–1 | 0.93 (0.73–1.19) | 0.566 |
| 2 | 0.91 (0.71–1.19) | 0.499 |
| 3–4 | 0.99 (0.79–1.24) | 0.927 |
| 5–12 | Ref. | |
| A1C | ||
| 8.0–9.0% | 1.32 (0.92–1.88) | 0.127 |
| >9.0% | 1.58 (1.15–2.17) | 0.005 |
| <8.0% | Ref. | |
| Healthcare utilization | ||
| Any inpatient visit | ||
| Yes | 1.16 (0.92–1.46) | 0.207 |
| No | Ref. | |
| Any ED visit | ||
| Yes | 0.73 (0.59–0.91) | 0.005 |
| No | Ref. | |
| Number of OADs | ||
| 1 | 1.18 (0.97–1.43) | 0.093 |
| 2 | 1.16 (0.94–1.43) | 0.174 |
| ≥3 | 1.63 (1.16–2.28) | 0.004 |
| No OAD | Ref. | |
| Complexities specific to older patients | ||
| Cognitive impairment | ||
| Yes | 1.34 (1.03–1.73) | 0.027 |
| No | Ref. | |
| Major depression | ||
| Yes | 0.89 (0.69–1.15) | 0.364 |
| No | Ref. | |
| Falls and falls risk | ||
| Yes | 1.01 (0.66–1.54) | 0.957 |
| No | Ref. | |
| Polypharmacy (>13 drugs) | ||
| Yes | 1.17 (0.92–1.49) | 0.209 |
| No | Ref. | |
| Urinary incontinence | ||
| Yes | 0.83 (0.55–1.26) | 0.388 |
| No | Ref. | |
| Average RAI out-of-pocket costs | ||
| $0 to <$6.40 | Ref. | |
| $6.40 to <$39.60 | 0.53 (0.42–0.67) | <0.001 |
| $39.60 to <$75.0 | 0.65 (0.52–0.81) | <0.001 |
| ≥$75.0 | 0.56 (0.44–0.70) | <0.001 |
aDCSI, adapted Diabetes Complications Severity Index; CI, confidence interval; ED, emergency department; HMO, health maintenance organization; OAD, oral antidiabetes drug; OR, odds ratio; PFFS, private fee-for-service; PPO, preferred provider organization; RAI, rapid-acting insulin; ref. reference, T2D type 2 diabetes.
*
Based on 3,927 elderly Medicare beneficiaries who had two or more claims for RAI during the 12-month follow-up period.