Table 3.
Factors potentially associated with hospital-based service utilisation, decedents aged ≥70 years, NSW, 2007 (n = 34,556)
| % | Unadjusted OR (95% CI) | Adjusted OR (95% CI)a | Adjusted p-valuea | |
|---|---|---|---|---|
| ≥1 Hospital episode | 82 | |||
| Male vs Female | 87 vs 78 | 1.89 (1.78–2.00) | 1.58 (1.48–1.67) | < 0.0001 |
| Age (OR per 5-year increase in age)b | 0.74 (0.72–0.75) | 0.82 (0.81–0.84)* | < 0.0001 | |
| 70–79 | 88 | 2.77 (2.57–2.99) | 1.83 (1.69–1.99) | |
| 80–89 | 84 | 2.02 (1.90–2.15) | 1.67 (1.56–1.79) | |
| 90+ | 72 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 0.95 (0.93–0.97) | 0.95 (0.92–0.97)* | < 0.0001 | |
| Most disadvantaged quintile | 85 | 1.28 (1.17–1.40) | 1.30 (1.17–1.44) | |
| Quintile 2 | 83 | 1.09 (1.00–1.19) | 1.07 (0.97–1.18) | |
| Quintile 3 | 82 | 1.03 (0.94–1.12) | 1.02 (0.93–1.12) | |
| Quintile 4 | 82 | 1.00 (0.92–1.10) | 0.96 (0.87–1.05) | |
| Least disadvantaged quintile | 82 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Place of residence: Other vs Major cities | 82 vs 83 | 0.95 (0.90–1.01) | 0.87 (0.82–0.94) | 0.0002 |
| Cancer vs Non-cancer death | 95 vs 78 | 5.16 (4.67–5.69) | 4.29 (3.88–4.74) | < 0.0001 |
| > 3 hospital episodes | 21 | |||
| Male vs Female | 25 vs 17 | 1.66 (1.58–1.75) | 1.38 (1.31–1.46) | < 0.0001 |
| Age (OR per 5-year increase in ageb | 0.73 (0.72–0.75) | 0.79 (0.78–0.81)* | < 0.0001 | |
| 70–79 | 29 | 3.32 (3.06–3.61) | 2.42 (2.22–2.64) | |
| 80–89 | 20 | 2.07 (1.92–2.25) | 1.77 (1.63–1.92) | |
| 90+ | 11 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 1.00 (0.98–1.02) | 1.01 (0.99–1.04)* | 0.24 | |
| Most disadvantaged quintile | 22 | 1.01 (0.93–1.10) | 0.96 (0.88–1.06) | |
| Quintile 2 | 21 | 0.97 (0.89–1.05) | 0.90 (0.82–0.98) | |
| Quintile 3 | 19 | 0.86 (0.79–0.93) | 0.82 (0.75–0.89) | |
| Quintile 4 | 21 | 0.96 (0.88–1.05) | 0.91 (0.84–1.00) | |
| Least disadvantaged quintile | 22 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Place of residence: Other vs Major cities | 20 vs 21 | 0.95 (0.90–1.00) | 0.95 (0.89–1.02) | 0.16 |
| Cancer vs Non-cancer death | 35 vs 16 | 2.78 (2.63–2.94) | 2.33 (2.20–2.47) | < 0.0001 |
| Prolonged single hospitalisation (> 30 days) | 21 | |||
| Male vs Female | 22 vs 20 | 1.16 (1.10–1.22) | 1.09 (1.03–1.15) | 0.002 |
| Age (OR per 5-year increase in age)b | 0.93 (0.91–0.95) | 0.96 (0.94–0.98)* | < 0.0001 | |
| 70–79 | 22 | 1.34 (1.25–1.45) | 1.18 (1.09–1.28) | |
| 80–89 | 22 | 1.32 (1.23–1.41) | 1.24 (1.16–1.33) | |
| 90+ | 17 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 1.02 (1.00–1.04) | 1.04 (1.02–1.06)* | 0.0003 | |
| Most disadvantaged quintile | 20 | 0.91 (0.84–0.99) | 0.85 (0.78–0.94) | |
| Quintile 2 | 20 | 0.93 (0.86–1.01) | 0.86 (0.79–0.94) | |
| Quintile 3 | 21 | 1.00 (0.92–1.08) | 0.96 (0.88–1.04) | |
| Quintile 4 | 20 | 0.93 (0.85–1.02) | 0.91 (0.84–1.00) | |
| Least disadvantaged quintile | 22 | 1.00 (reference) | 1.00 (reference) | 0.002 |
| Place of residence: Other vs Major cities | 21 vs 20 | 1.06 (1.00–1.12) | 1.11 (1.04–1.18) | 0.002 |
| Cancer vs Non-cancer death | 26 vs 19 | 1.51 (1.43–1.60) | 1.45 (1.37–1.54) | < 0.0001 |
| > 3 months total hospitalisation | 7 | |||
| Male vs Female | 7 vs 6 | 1.11 (1.02–1.21) | 1.02 (0.94–1.11) | 0.64 |
| Age (OR per 5-year increase in age)b | 0.86 (0.84–0.89) | 0.87 (0.84–0.89)* | < 0.0001 | |
| 70–79 | 8 | 1.77 (1.56–2.01) | 1.72 (1.51–1.96) | |
| 80–89 | 7 | 1.45 (1.29–1.64) | 1.43 (1.27–1.62) | |
| 90+ | 5 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 0.93 (0.90–0.95) | 0.99 (0.95–1.02)* | 0.52 | |
| Most disadvantaged quintile | 8 | 1.35 (1.17–1.55) | 1.07 (0.92–1.24) | |
| Quintile 2 | 7 | 1.23 (1.07–1.41) | 0.98 (0.85–1.14) | |
| Quintile 3 | 7 | 1.18 (1.03–1.35) | 1.03 (0.89–1.19) | |
| Quintile 4 | 6 | 1.03 (0.88–1.19) | 0.97 (0.84–1.13) | |
| Least disadvantaged quintile | 6 | 1.00 (reference) | 1.00 (reference) | 0.67 |
| Place of residence: Other vs Major cities | 8 vs 6 | 1.46 (1.34–1.59) | 1.41 (1.28–1.56) | < 0.0001 |
| Cancer vs Non-cancer death | 7 vs 6 | 1.16 (1.05–1.27) | 1.05 (0.96–1.16) | 0.29 |
| ICU admission | 9 | |||
| Male vs Female | 11 vs 8 | 1.57 (1.46–1.68) | 1.29 (1.19–1.39) | < 0.0001 |
| Age (OR per 5-year increase in age)b | 0.65 (0.63–0.67) | 0.65 (0.63–0.67)* | < 0.0001 | |
| 70–79 | 16 | 6.03 (5.24–6.94) | 6.05 (5.24–6.99) | |
| 80–89 | 9 | 3.10 (2.70–3.57) | 3.06 (2.66–3.53) | |
| 90+ | 3 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 0.94 (0.91–0.96) | 0.94 (0.91–0.96)* | < 0.0001 | |
| Most disadvantaged quintile | 13 | 1.29 (1.16–1.44) | 1.30 (1.15–1.46) | |
| Quintile 2 | 9 | 0.83 (0.74–0.94) | 0.84 (0.74–0.95) | |
| Quintile 3 | 8 | 0.81 (0.72–0.90) | 0.80 (0.71–0.90) | |
| Quintile 4 | 8 | 0.77 (0.68–0.88) | 0.73 (0.64–0.82) | |
| Least disadvantaged quintile | 10 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Place of residence: Other vs Major cities | 8 vs 10 | 0.81 (0.74–0.87) | 0.72 (0.66–0.79) | < 0.0001 |
| Cancer vs Non-cancer death | 9 vs 9 | 0.98 (0.90–1.07) | 0.72 (0.66–0.79) | < 0.0001 |
| ≥1 ED presentationc | 79 | |||
| Male vs Female | 83 vs 76 | 1.56 (1.46–1.67) | 1.42 (1.32–1.53) | < 0.0001 |
| Age (OR per 5-year increase in ageb | 0.83 (0.81–0.85) | 0.88 (0.86–0.90)* | < 0.0001 | |
| 70–79 | 84 | 1.94 (1.77–2.12) | 1.55 (1.41–1.71) | |
| 80–89 | 80 | 1.54 (1.42–1.67) | 1.37 (1.27–1.49) | |
| 90+ | 73 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 0.79 (0.77–0.81) | 0.80 (0.78–0.82)* | < 0.0001 | |
| Most disadvantaged quintile | 87 | 2.68 (2.38–3.02) | 2.53 (2.25–2.85) | |
| Quintile 2 | 84 | 2.02 (1.82–2.24) | 1.91 (1.71–2.12) | |
| Quintile 3 | 83 | 1.95 (1.76–2.17) | 1.90 (1.71–2.12) | |
| Quintile 4 | 80 | 1.57 (1.44–1.71) | 1.53 (1.40–1.67) | |
| Least disadvantaged quintile | 72 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Place of residence: Other vs Major cities | 82 vs 79 | 1.16 (1.00–1.35) | 1.02 (0.88–1.20) | 0.75 |
| Cancer vs Non-cancer death | 83 vs 78 | 1.33 (1.23–1.44) | 1.17 (1.07–1.27) | 0.0003 |
| > 3 ED presentationsc | 17 | |||
| Male vs Female | 20 vs 14 | 1.46 (1.35–1.56) | 1.34 (1.24–1.44) | < 0.0001 |
| Age (OR per 5-year increase in age)b | 0.85 (0.83–0.87) | 0.88 (0.86–0.91)* | < 0.0001 | |
| 70–79 | 20 | 1.91 (1.72–2.13) | 1.63 (1.45–1.82) | |
| 80–89 | 17 | 1.54 (1.40–1.71) | 1.41 (1.27–1.56) | |
| 90+ | 12 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 0.84 (0.82–0.87) | 0.86 (0.84–0.88)* | < 0.0001 | |
| Most disadvantaged quintile | 22 | 2.02 (1.80–2.26) | 1.90 (1.69–2.13) | |
| Quintile 2 | 21 | 1.90 (1.71–2.13) | 1.77 (1.58–1.98) | |
| Quintile 3 | 16 | 1.41 (1.25–1.59) | 1.37 (1.22–1.55) | |
| Quintile 4 | 17 | 1.45 (1.31–1.61) | 1.40 (1.26–1.56) | |
| Least disadvantaged quintile | 12 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Place of residence: Other vs Major cities | 21 vs 17 | 1.32 (1.14–1.52) | 1.15 (0.99–1.33) | 0.07 |
| Cancer vs Non-cancer death | 18 vs 16 | 1.17 (1.08–1.27) | 1.04 (0.96–1.13) | 0.33 |
| Palliative care input: broader definitiond,e | 21 | |||
| Male vs Female | 24 vs 18 | 1.39 (1.32–1.47) | 1.04 (0.98–1.10) | 0.21 |
| Age (OR per 5-year increase in age)b | 0.72 (0.71–0.73) | 0.85 (0.83–0.86)* | < 0.0001 | |
| 70–79 | 30 | 3.37 (3.11–3.65) | 1.84 (1.68–2.02) | |
| 80–89 | 19 | 1.86 (1.72–2.01) | 1.37 (1.25–1.49) | |
| 90+ | 11 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 1.05 (1.03–1.07) | 1.02 (1.00–1.05)* | 0.05 | |
| Most disadvantaged quintile | 22 | 0.93 (0.85–1.01) | 1.05 (0.95–1.16) | |
| Quintile 2 | 19 | 0.77 (0.71–0.84) | 0.73 (0.66–0.80) | |
| Quintile 3 | 18 | 0.75 (0.69–0.81) | 0.73 (0.66–0.80) | |
| Quintile 4 | 24 | 1.03 (0.95–1.12) | 1.01 (0.92–1.11) | |
| Least disadvantaged quintile | 23 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Place of residence: Other vs Major cities | 18 vs 22 | 0.74 (0.70–0.78) | 0.73 (0.68–0.79) | < 0.0001 |
| Cancer vs Non-cancer death | 54 vs 10 | 11.13 (10.49–11.81) | 10.24 (9.63–10.89) | < 0.0001 |
| Death in inpatient setting | 53 | |||
| Male vs Female | 59 vs 49 | 1.55 (1.48–1.61) | 1.31 (1.25–1.37) | < 0.0001 |
| Age (OR per 5-year increase in age)b | 0.75 (0.74–0.76) | 0.80 (0.79–0.82)* | < 0.0001 | |
| 70–79 | 64 | 2.83 (2.66–3.00) | 2.17 (2.04–2.31) | |
| 80–89 | 54 | 1.82 (1.73–1.92) | 1.60 (1.51–1.69) | |
| 90+ | 39 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Socioeconomic quintile (OR per increase in quintile) | 0.92 (0.90–0.93) | 0.93 (0.92–0.95)* | < 0.0001 | |
| Most disadvantaged quintile | 59 | 1.41 (1.31–1.51) | 1.34 (1.24–1.45) | |
| Quintile 2 | 56 | 1.25 (1.17–1.34) | 1.17 (1.09–1.26) | |
| Quintile 3 | 52 | 1.08 (1.01–1.15) | 1.03 (0.96–1.11) | |
| Quintile 4 | 51 | 1.06 (0.99–1.13) | 1.01 (0.94–1.09) | |
| Least disadvantaged quintile | 50 | 1.00 (reference) | 1.00 (reference) | < 0.0001 |
| Place of residence: Other vs Major cities | 55 vs 53 | 1.08 (1.04–1.13) | 0.99 (0.94–1.04) | 0.62 |
| Cancer vs Non-cancer death | 68 vs 48 | 2.31 (2.20–2.44) | 1.96 (1.86–2.06) | < 0.0001 |
OR odds ratio, CI confidence interval, ICU intensive care unit, ED emergency department
aAdjusted for sex, age group, socioeconomic quintile (category), place of residence and cause of death, unless otherwise noted
bThe differences in healthcare utilisation associated with age were similar when age was analysed by age group or by 5-year age increments
cAmong the 21,544 people resident in the geographical area where recording of ED presentations was complete
dPatients already captured in restricted definition, plus those referred to palliative care specialist teams or facilities, availing of a palliative care bed, and/or where service category/service-related group/diagnosis code indicated palliative care
eResults were similar for restricted definition of palliative care. (Restricted definition includes persons recorded as undergoing review by a specialist palliative care team or who were admitted to one of five stand-alone hospice/inpatient palliative care facilities in NSW)
*Adjusted for sex, 5-year increase in age, socioeconomic quintile (ordinal scale 1–5), place of residence and cause of death