Table 2.

Within Hospital Fixed Effects Association of Hospice Referral and Physician Type During Hospitalizations of Nursing Home Residents with Advanced Dementia, 2000–2010

	Bivariate models, OR (95% CI)	Model 1: Adjusting for patient characteristics and physician type	Model 2: Adjusting for all + pre-admission continuity	Model 3: Adjusting for all + % hospital admissions cared for by hospitalist
Physician Type:
Generalist	(reference)	(reference)	(reference)	(reference)
Hospitalist	1.27 (1.19–1.36)*	1.29 (1.20–1.40)*	1.17 (1.09–1.26)*	0.97 (0.89–1.06)
Specialist	1.01 (0.92–1.13)	1.06 (0.94–1.19)	0.98 (0.89–1.11)	0.97 (0.86–1.09)
Pre-admission continuity:
Generalist continuity	–	–	0.78 (0.73–0.85)*	0.78 (0.73–0.84)*
Specialist continuity	–	–	0.83 (0.70–0.97)*	0.83 (0.70–0.97)*
Highest vs. lowest decile of hospitalist prevalence	–	–	–	1.75 (1.50–1.86)*

Data source: Medicare claims data. All models adjusted for: DNR/DNH orders, ADL, cognitive performance scale, CHESS score, age, race, pre-admit diagnoses including Parkinson’s, bipolar disease, schizophrenia, COPD, Alzheimer’s, renal failure, hip fracture, pneumonia, length of stay, time between admission and minimum data set assessment. Models 2 and 3 additionally adjust for if a billing generalist or specialist for the admission had billed a patient visit prior to the admission. Model 3 additionally adjusts for the % of hospital admissions cared for by hospitalists for a hospital, measured in deciles of all US hospitals sampled.

^*p-value<0.05