Table 3.
Predictors of Transfer of Emergency General Surgery Patients to Acute Care Hospitals in the Nationwide Inpatient Sample 2008–2013
| Parameter | Hazard Ratio | 95% Hazard Ratio Confidence Limits |
|---|---|---|
| Gender | ||
| Male | 1.09 | (1.07–1.11) |
| Female | Reference | |
| Age | 0.99 | (0.99–1.00) |
| Race | ||
| Black | 0.91 | (0.86–0.96) |
| Hispanic | 0.84 | (0.78–0.91) |
| Other | 1.00 | (0.93–1.08) |
| Missing | 1.08 | (1.01–1.16) |
| White | Reference | |
| Expected primary payer | ||
| Medicare | 0.92 | (0.89–0.95) |
| Medicaid | 0.85 | (0.81–0.88) |
| Self-pay | 0.65 | (0.61–0.69) |
| No charge | 0.57 | (0.46–0.70) |
| Other | 1.14 | (1.05–1.23) |
| Private insurance | Reference | |
| Household income of patient’s zip code (median) | ||
| 26th to 50th percentile | 0.92 | (0.88–0.96) |
| 51st to 75th percentile | 0.88 | (0.84–0.93) |
| 76th to 100th percentile | 0.89 | (0.84–0.95) |
| 0–25th percentile | Reference | |
| Charlson Comorbidity Index | ||
| 1 | 0.97 | (0.94–0.99) |
| 2 | 1.08 | (1.04–1.11) |
| 3 | 1.16 | (1.12–1.20) |
| 0 | Reference | |
| EGS diagnosis group | ||
| Resuscitation Yes | 0.61 | (0.44–0.86) |
| Resuscitation No | Reference | |
| General abdominal conditions Yes | 0.71 | (0.60–0.84) |
| General abdominal conditions No | Reference | |
| Intestinal obstruction Yes | 0.62 | (0.53–0.73) |
| Intestinal obstruction No | Reference | |
| Upper gastrointestinal tract Yes | 0.42 | (0.36–0.50) |
| Upper gastrointestinal tract No | Reference | |
| Hepatic-pancreatic-biliary Yes | 0.64 | (0.54–0.75) |
| Hepatic-pancreatic-biliary No | Reference | |
| Colorectal Yes | 0.22 | (0.18–0.25) |
| Colorectal No | Reference | |
| Hernias Yes | 0.70 | (0.59–0.83) |
| Hernias No | Reference | |
| Soft tissue Yes | 0.21 | (0.18–0.25) |
| Soft tissue No | Reference | |
| Vascular Yes | 0.39 | 0.33–0.46) |
| Vascular No | Reference | |
| Cardiothoracic Yes | 0.93 | (0.76–1.13) |
| Cardiothoracic No | Reference | |
| Procedure type | ||
| Colon | 0.26 | (0.24–0.28) |
| Amputation | 0.41 | (0.31–0.56) |
| Anorectal | 0.43 | (0.34–0.54) |
| Appendix | 0.10 | (0.09–0.12) |
| Bladder | 0.30 | (0.17–0.54) |
| Cardiothoracic | 0.33 | (0.29–0.38) |
| Cholecystectomy | 0.16 | (0.15–0.17) |
| Ear, nose, and throat | 0.36 | (0.30–0.43) |
| Exploratory laparotomy | 0.54 | (0.44–0.65) |
| Stomach | 0.42 | (0.39–0.46) |
| Hernia | 0.11 | (0.10–0.13) |
| Laparoscopy | 0.44 | (0.30–0.64) |
| Hepatobiliary | 0.29 | (0.21–0.39) |
| Lysis of adhesions | 0.16 | (0.14–0.18) |
| Orthopedic or soft tissue | 0.59 | (0.55–0.63) |
| Pancreas | 0.31 | (0.24–0.39) |
| Kidney | 0.90 | (0.34–2.38) |
| Small bowel | 0.24 | (0.22–0.26) |
| Vascular | 0.56 | (0.50–0.63) |
| No procedure | Reference | |
| Day of Admission | ||
| Admitted Saturday-Sunday | 1.04 | (1.02–1.07) |
| Admitted Monday-Friday | Reference | |
| Total number of discharges | 1.00 | (1.00–1.00) |
| Hospital Bed Size | ||
| Small | 2.52 | (2.28–2.79) |
| Medium | 1.32 | (1.21–1.44) |
| Large | 1.00 | |
| Hospital Region | ||
| Midwest | 1.13 | (1.03–1.23) |
| South | 0.83 | (0.76–0.91) |
| West | 0.97 | (0.89–1.07) |
| Northeast | Reference | |
| Hospital Ownership | ||
| Government, nonfederal | 1.19 | (1.11–1.28) |
| Private, invest-own | 0.96 | (0.89–1.03) |
| Private, not-profit | Reference | |
| Hospital Location/Teaching Status | ||
| Rural | 4.58 | (3.98–5.27) |
| Urban nonteaching | 1.89 | (1.70–2.10) |
| Urban teaching | Reference | |