Table 4.
Estimated odds ratios (ORs) and 95% confidence intervals (CI) for associations between parameters and increase in hospitalization rate category (0 to >0 hospitalizations/year or 0–2 to >2 hospitalizations/year) from multi-level ordinal logistic regression models with clustering by transplant center and OPO.
| Parameter | Model | |||||
|---|---|---|---|---|---|---|
|
| ||||||
| Model 1 N=53 810 |
Model 2 (dialysis-dependent) N=52 760 |
Model 3 (regional health resources) N=53 495 |
||||
| OR | 95% CI | OR | 95% CI | OR | 95% CI | |
| Age (Ref. ≤40) | ||||||
| 41–55 | 1.079 | (1.024, 1.137) | 1.094 | (1.037, 1.153) | 1.080 | (1.025, 1.138) |
| 56–69 | 1.163 | (1.101, 1.228) | 1.185 | (1.121, 1.252) | 1.166 | (1.104, 1.231) |
| 70–90 | 1.123 | (1.040, 1.212) | 1.154 | (1.068, 1.248) | 1.124 | (1.041, 1.214) |
| Female (Ref. Male) | 1.120 | (1.080, 1.160) | 1.110 | (1.071, 1.151) | 1.121 | (1.082, 1.162) |
| Race/ethnicity (Ref. White nonHispanic) | ||||||
| Black nonHispanic | 1.007 | (0.964, 1.052) | 1.006 | (0.963, 1.051) | 0.986 | (0.943, 1.031) |
| Black Hispanic | 1.015 | (0.776, 1.328) | 1.022 | (0.781, 1.338) | 0.988 | (0.755, 1.294) |
| White Hispanic | 0.837 | (0.791, 0.886) | 0.838 | (0.792, 0.887) | 0.824 | (0.779, 0.873) |
| Asian | 0.759 | (0.700, 0.823) | 0.760 | (0.700, 0.824) | 0.754 | (0.695, 0.818) |
| Other | 0.909 | (0.792, 1.043) | 0.917 | (0.797, 1.055) | 0.907 | (0.789, 1.044) |
| BMI (Ref. normal) | ||||||
| Underweight | 1.017 | (0.926, 1.118) | 1.023 | (0.931, 1.125) | 1.017 | (0.926, 1.118) |
| Overweight | 0.996 | (0.953, 1.040) | 1.002 | (0.959, 1.047) | 0.995 | (0.952, 1.039) |
| Obese | 1.031 | (0.988, 1.076) | 1.04 | (0.997, 1.086) | 1.029 | (0.986, 1.073) |
| Years on dialysis at waitlisting (Ref. 0) | 1.193 | (1.170, 1.217) | 1.18 | (1.154, 1.207) | 1.193 | (1.17, 1.216) |
| ESRD Cause (Ref. Other) | ||||||
| Diabetes | 1.417 | (1.340, 1.499) | 1.420 | (1.342, 1.503) | 1.417 | (1.340, 1.499) |
| Hypertension | 0.958 | (0.903, 1.017) | 0.962 | (0.906, 1.022) | 0.954 | (0.899, 1.013) |
| Kidney disease | 0.898 | (0.845, 0.955) | 0.904 | (0.850, 0.962) | 0.899 | (0.845, 0.956) |
| Cancer history | 1.091 | (0.992, 1.200) | 1.105 | (1.004, 1.216) | 1.092 | (0.993, 1.201) |
| Tobacco smoker | 1.328 | (1.235, 1.429) | 1.327 | (1.233, 1.429) | 1.331 | (1.237, 1.432) |
| Insurance at ESRD start (Ref. Private) | ||||||
| Medicaid | 1.461 | (1.388, 1.539) | 1.489 | (1.413, 1.569) | 1.469 | (1.395, 1.547) |
| Medicare | 1.274 | (1.207, 1.343) | 1.296 | (1.228, 1.368) | 1.278 | (1.211, 1.348) |
| Other | 0.940 | (0.879, 1.005) | 0.945 | (0.883, 1.011) | 0.943 | (0.882, 1.008) |
| None | 1.083 | (1.023, 1.147) | 1.075 | (1.014, 1.138) | 1.086 | (1.026, 1.150) |
| PRA (Ref. 0) | ||||||
| >0 and ≤80 | 1.076 | (1.036, 1.118) | 1.076 | (1.035, 1.118) | 1.079 | (1.038, 1.120) |
| >80 | 1.375 | (1.289, 1.467) | 1.370 | (1.283, 1.463) | 1.379 | (1.292, 1.471) |
| Listing year (Ref. 2013) | ||||||
| 2005 | 4.753 | (4.396, 5.139) | 4.560 | (4.166, 4.991) | 4.763 | (4.404, 5.151) |
| 2006 | 4.743 | (4.394, 5.119) | 4.650 | (4.285, 5.047) | 4.744 | (4.394, 5.121) |
| 2007 | 5.115 | (4.741, 5.518) | 5.108 | (4.726, 5.522) | 5.109 | (4.735, 5.514) |
| 2008 | 5.030 | (4.662, 5.428) | 5.093 | (4.714, 5.501) | 5.013 | (4.646, 5.411) |
| 2009 | 5.785 | (5.363, 6.239) | 5.860 | (5.429, 6.326) | 5.798 | (5.375, 6.254) |
| 2010 | 5.941 | (5.509, 6.406) | 6.006 | (5.566, 6.481) | 5.945 | (5.512, 6.412) |
| 2011 | 4.627 | (4.286, 4.996) | 4.637 | (4.291, 5.009) | 4.653 | (4.309, 5.025) |
| 2012 | 3.116 | (2.885, 3.367) | 3.119 | (2.885, 3.372) | 3.121 | (2.889, 3.373) |
| Blood Type (Ref. O) | ||||||
| AB | 0.663 | (0.608, 0.724) | 0.660 | (0.604, 0.721) | 0.660 | (0.604, 0.721) |
| A | 0.824 | (0.794, 0.855) | 0.824 | (0.794, 0.856) | 0.823 | (0.793, 0.854) |
| B | 0.999 | (0.952, 1.048) | 0.999 | (0.951, 1.049) | 0.996 | (0.948, 1.045) |
| Percent of households below poverty line (Ref. <15%) | 0.970 | (0.933, 1.010) | 0.969 | (0.931, 1.009) | 0.988 | (0.947, 1.031) |
| ≥85% adults with HS diploma (Ref. <85%) | 1.020 | (0.974, 1.067) | 1.015 | (0.969, 1.062) | 1.020 | (0.974, 1.068) |
| Willing to accept expanded criteria organ | 0.966 | (0.928, 1.005) | 0.963 | (0.925, 1.003) | 0.964 | (0.926, 1.003) |
| Dialysis access type (Ref. catheter) | ||||||
| AVF | 0.791 | (0.751, 0.834) | ||||
| Graft | 0.960 | (0.862, 1.070) | ||||
| Peritoneal | 1.031 | (0.974, 1.092) | ||||
| Other | 1.032 | (0.976, 1.091) | ||||
| Urban county of residence (Ref. rural) | 1.185 | (1.124, 1.249) | ||||
| Hospital beds ≤2.069/1000 persons (Ref. >2.069) | 0.926 | (0.888, 0.966) | ||||
| PCPs ≤70.3/100 000 persons (Ref. >70.3) | 1.007 | (0.968, 1.047) | ||||
| Nephrologists ≤2.27/100 000 persons (Ref. >2.27) | 1.022 | (0.984, 1.062) | ||||
| UNOS region (Ref. 11) | ||||||
| 1 | 1.448 | (0.892, 2.352) | ||||
| 2 | 1.247 | (0.943, 1.648) | ||||
| 3 | 1.113 | (0.854, 1.451) | ||||
| 4 | 1.181 | (0.874, 1.594) | ||||
| 5 | 1.109 | (0.852, 1.445) | ||||
| 6 | 0.819 | (0.565, 1.189) | ||||
| 7 | 1.192 | (0.890, 1.596) | ||||
| 8 | 1.027 | (0.741, 1.425) | ||||
| 9 | 1.357 | (0.986, 1.867) | ||||
| 10 | 1.083 | (0.823, 1.426) | ||||
Abbreviations: AVF, arteriovenous fistula; BMI, body mass index; CKD, chronic kidney disease; ESRD, end-stage renal disease; HS, high school; HSA, hospital service area; LOS, hospital length of stay; PCPs, primary care physicians; PRA, panel reactive antibody; Ref., referent group.