Table 3.
Adjusted Odds Ratios and 95% Confidence Intervals from Survey Logistic Regression Representing Factors Associated with Readmission Frequency and Patterns (Nationwide Readmissions Database, 2010–2014)
| Number of readmissions with the 270-day follow-up | |||
|---|---|---|---|
| 1 | 2+ Non-clustered | 2+ Clustered | |
| HRRP era | |||
| Pre-HRRP | Ref | Ref | Ref |
| Post-HRRP | 0.95 (0.93, 0.96)* | 0.87 (0.85, 0.89)* | 0.88 (0.86, 0.90)* |
| Sex | |||
| Female | 0.93 (0.92, 0.94)* | 0.97 (0.95, 0.99)* | 0.87 (0.86, 0.89)* |
| Age at admission (years) | |||
| 18–44 | 0.89 (0.87, 0.92)* | 2.03 (1.94, 2.13)* | 2.49 (2.39, 2.58)* |
| 45–64 | 1.01 (0.99, 1.02) | 1.61 (1.55, 1.67)* | 1.70 (1.65, 1.75)* |
| 65–79 | 1.00 (0.99, 1.01) | 1.27 (1.23, 1.31)* | 1.28 (1.25, 1.32)* |
| 80+ | Ref | Ref | Ref |
| Zip code–level household income | |||
| Lowest quartile | 1.09 (1.07, 1.10)* | 1.24 (1.20, 1.29)* | 1.21 (1.18, 1.26)* |
| 2nd quartile | 1.04 (1.02, 1.06)* | 1.11 (1.07, 1.15)* | 1.10 (1.06, 1.13)* |
| 3rd quartile | 1.03 (1.01, 1.04)* | 1.03 (0.99, 1.07) | 1.06 (1.02, 1.09)* |
| Highest quartile | Ref | Ref | Ref |
| Primary insurance | |||
| Medicare | 1.43 (1.40, 1.46)* | 2.04 (1.95, 2.13)* | 2.12 (2.04, 2.19)* |
| Medicaid | 1.53 (1.50, 1.56)* | 2.29 (2.20, 2.40)* | 2.57 (2.47, 2.67)* |
| Private | Ref | Ref | Ref |
| Self-pay, no charge, other | 1.01 (0.99, 1.04) | 1.13 (1.07, 1.19)* | 1.18 (1.13, 1.24)* |
| Discharge disposition | |||
| Home/self-care | Ref | Ref | Ref |
| Transfer/home health | 1.35 (1.34, 1.37)* | 1.26 (1.22, 1.29)* | 1.28 (1.26, 1.31)* |
| Against medical advice | 1.84 (1.78, 1.91)* | 1.81 (1.68, 1.94)* | 2.62 (2.49, 2.75)* |
| Emergency department services | |||
| ED-related | 1.11 (1.09, 1.12)* | 1.32 (1.28, 1.37)* | 1.38 (1.34, 1.43)* |
| Patient location | |||
| Large central metro | Ref | Ref | Ref |
| Large fringe metro | 1.03 (1.01, 1.05)* | 1.03 (0.99, 1.06) | 1.03 (0.99, 1.06) |
| Medium metro | 0.95 (0.94, 0.97)* | 0.90 (0.87, 0.94)* | 0.86 (0.83, 0.89)* |
| Small metro | 0.95 (0.93, 0.97)* | 0.90 (0.86, 0.94)* | 0.86 (0.82, 0.89)* |
| Micropolitan | 0.92 (0.89, 0.95)* | 0.83 (0.77, 0.88)* | 0.78 (0.73, 0.83)* |
| Non-core | 0.91 (0.88, 0.94)* | 0.78 (0.73, 0.84)* | 0.72 (0.68, 0.77)* |
| Patient residency | |||
| Resident | 1.45 (1.40, 1.50)* | 1.87 (1.70, 2.07)* | 1.75 (1.63, 1.88)* |
| Severity of illness | |||
| Minor loss of function | Ref | Ref | Ref |
| Moderate loss of function | 1.33 (1.31, 1.36)* | 1.47 (1.40, 1.53)* | 1.51 (1.46, 1.57)* |
| Major loss of function | 1.64 (1.61, 1.68)* | 1.79 (1.71, 1.88)* | 1.87 (1.79, 1.94)* |
| Extreme loss of function | 1.86 (1.81, 1.91)* | 1.79 (1.69, 1.90)* | 1.94 (1.85, 2.04)* |
| Hospital bed size | |||
| Small | Ref | Ref | Ref |
| Medium | 1.01 (0.99, 1.03) | 1.06 (1.01, 1.10)* | 1.06 (1.02, 1.10)* |
| Large | 1.05 (1.03, 1.07)* | 1.08 (1.04, 1.12)* | 1.09 (1.05, 1.13)* |
| Hospital type | |||
| Non-metro hospital | Ref | Ref | Ref |
| Metro non-teaching | 1.01 (0.98, 1.04) | 0.94 (0.89, 1.01) | 1.04 (0.98, 1.10) |
| Metro teaching | 1.04 (1.00, 1.07)* | 0.96 (0.90, 1.03) | 1.05 (0.99, 1.12) |
| ACSC type | |||
| Chronic | 1.37 (1.36, 1.39)* | 2.69 (2.62, 2.76)* | 2.03 (1.99, 2.07)* |
| Acute | Ref | Ref | Ref |
| ECI number | |||
| 0 | Ref | Ref | Ref |
| 1 | 1.12 (1.09, 1.15)* | 1.15 (1.07, 1.23)* | 1.21 (1.14, 1.28)* |
| 2 | 1.25 (1.21, 1.28)* | 1.37 (1.29, 1.47)* | 1.49 (1.40, 1.58)* |
| 3–4 | 1.44 (1.40, 1.48)* | 1.74 (1.63, 1.85)* | 1.98 (1.87, 2.09)* |
| 5–6 | 1.70 (1.65, 1.74)* | 2.26 (2.11, 2.42)* | 2.60 (2.45, 2.76)* |
| 7+ | 1.97 (1.91, 2.05)* | 2.76 (2.55, 2.98)* | 3.34 (3.13, 3.57)* |
The 0 readmissions group is the reference outcome level
*Significance at p < 0.05