Table 2.
Adjusted Odds of Advance Care Planning Preferences (N = 558)
| Variable | Category | Advance care planning | Circumstances of death | |||
|---|---|---|---|---|---|---|
| Goals of care documented | Physician Orders for Life-Sustaining Treatment | Code status: do not resuscitate | Hospice involvement | Location of death at home | ||
| Primary variable of interest | Palliative care | 96.93*** | 24.06*** | 7.71*** | 11.70*** | 2.23* |
| Nonpalliative care | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | |
| Age | 0–30 days | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) |
| 31–364 days | 0.56 | 3.52 | 0.33** | 1.54 | 4.85* | |
| 1–4 years | 0.62 | 2.32 | 0.37* | 0.78 | 1.42 | |
| 5–9 years | 0.21 | 1.26 | 0.16** | 1.15 | 0.93 | |
| 10–14 years | 0.27 | 1.74 | 0.25** | 0.57 | 0.65 | |
| 15+ years | 0.62 | 1.79 | 0.19*** | 0.85 | 1.39 | |
| Diagnosis | Cardiac | 0.26 | 0.09* | 0.14** | 1.00 | 0.24 |
| Congenital heart disease | 0.45 | 0.82 | 0.15*** | 0.81 | 0.51 | |
| Congenital malformation and genetic | 0.67 | 1.05 | 0.76 | 1.1 | 0.58 | |
| Infection | 0.15 | 1.00 | 0.13* | 1.00 | 1.00 | |
| Malignancy | 1.39 | 0.38 | 1.94 | 2.48 | 1.80 | |
| Neurologic | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | |
| Complications of prematurity | 0.95 | 0.59 | 0.47 | 1.00 | 0.28 | |
| Respiratory | 1.03 | 0.21 | 0.90 | 0.13* | 0.18* | |
| Trauma | 0.17* | 0.18 | 0.63 | 1.00 | 0.43 | |
| Other | 0.36 | 1.00 | 0.21* | 1.00 | 0.14** | |
| Primary place of care | Neonatal intensive care unit | 0.33 | 0.22 | 0.94 | 0.93 | 3.71 |
| Pediatric intensive care unit | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | |
| Inpatient | 1.50 | 13.95*** | 0.83 | 7.67** | 20.61*** | |
| Outpatient | 0.71 | 16.32*** | 0.26** | 16.36*** | 60.33*** | |
| Other | 0.10* | 6.77 | 0.24* | 5.71 | 25.93*** | |
| Religion | Documented | 0.48* | 1.31 | 1.13 | 1.01 | 1.52 |
| Not documented | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | |
| Rural Urban Commuting Area | Urban | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) |
| Large rural | 0.54 | 0.73 | 0.98 | 0.47 | 0.32* | |
| Small rural | 1.18 | 1.56 | 2.09* | 2.07 | 1.89 | |
| Isolated | 1.12 | 0.25 | 0.99 | 0.53 | 0.72 | |
| Year of death | 2012 | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) | 1.00 (ref.) |
| 2013 | 1.62 | 4.32 | 0.96 | 1.74 | 1.99 | |
| 2014 | 2.43 | 6.80* | 0.55 | 1.50 | 0.86 | |
| 2015 | 3.26* | 7.61** | 2.06* | 0.94 | 0.49 | |
| 2016 | 2.52 | 8.77** | 1.07 | 0.97 | 1.17 | |
Coefficients presented above are odds ratios of each advance care planning model (goals documented, POLST completion, code status, hospice, preferred place of death at home, and actual location of death at home).Reference values were selected based on the largest sample size across the distribution; an exception was made for year, where the first year of the study was selected. *p < 0.05, **p < 0.01, ***p < 0.001.
POLST, Physician Orders for Life-Sustaining Treatment.