Table 1.
Adjusted Odds of Potentially Preventable Hospitalizations With Co-Existing Depression by Hospital ACO Affiliation, 2015
| Variable | OR (95% CI) |
|---|---|
| Hospital affiliation | |
| ACO-unaffiliated | ref |
| ACO-affiliated | 0.89 (0.87, 0.91) |
| Individual characteristics | |
| Race/Ethnicity | |
| NH white | ref |
| NH African American | 1.60 (1.55, 1.66) |
| NH Asian or Pacific Islander | 1.10 (0.96, 1.26) |
| NH Native American | 0.95 (0.84, 1.08) |
| NH other/multi-race | 1.12 (1.00, 1.25) |
| Hispanic (any race) | 1.11 (1.06, 1.16) |
| Age, years | |
| 18–24 | ref |
| 25–34 | 0.60 (0.56, 0.65) |
| 35–44 | 0.68 (0.63, 0.73) |
| 45–54 | 0.85 (0.80, 0.91) |
| 55–64 | 0.89 (0.83, 0.95) |
| 65–74 | 0.85 (0.80, 0.92) |
| ≥75 | 0.91 (0.85, 0.98) |
| Sex | |
| Male | ref |
| Female | 1.10 (1.08, 1.13) |
| Chronic conditions | 1.16 (1.16, 1.17) |
| Payer | |
| Medicare | ref |
| Medicaid | 1.06 (1.02, 1.09) |
| Private insurance | 0.68 (0.66, 0.70) |
| Self-pay | 1.22 (1.15, 1.30) |
| No charge | 1.09 (0.95, 1.26) |
| Other | 0.71 (0.66, 0.76) |
| Median income of ZIP code | |
| $1-$41,999 | ref |
| $42,000-$51,999 | 0.93 (0.90, 0.96) |
| $52,000-$67,999 | 0.87 (0.85, 0.90) |
| ≥$68,000 | 0.78 (0.75, 0.81) |
| 4th quarter discharge | 1.12 (1.09, 1.15) |
| Hospital characteristics | |
| Hospital ownership | |
| For-profit | ref |
| Non-for-profit | 0.91 (0.87, 0.94) |
| Government | 0.91 (0.87, 0.96) |
| Bed size | |
| Small ≤50 | ref |
| Medium 51–200 | 0.78 (0.73, 0.83) |
| Large >200 | 0.61 (0.58, 0.65) |
| Teaching status | |
| Non-teaching | ref |
| Teaching | 0.76 (0.74, 0.79) |
| Safety net provider | |
| No | ref |
| Yes | 0.98 (0.94, 1.01) |
| Geography | |
| Urban | ref |
| Rural | 1.27 (1.22, 1.33) |
| State | |
| Florida | ref |
| Arizona | 0.77 (0.73, 0.81) |
| Colorado | 0.66 (0.62, 0.69) |
| Kentucky | 0.98 (0.94, 1.02) |
| Maryland | 1.00 (0.96, 1.05) |
| North Carolina | 0.95 (0.92, 0.99) |
| New Jersey | 1.35 (1.28, 1.42) |
| Oregon | 0.71 (0.67, 0.74) |
| Rhode Island | 1.37 (1.25, 1.50) |
| Washington | 0.78 (0.74, 0.82) |
| Wisconsin | 0.73 (0.70, 0.77) |
| Constant | 0.07 (0.06, 0.08) |
Notes: Total sample (N=400,222) includes discharges for adult adults with depression from 682 hospitals in 11 states (Florida, Arizona, Colorado, Kentucky, Maryland, North Carolina, New Jersey, Oregon, Rhode Island, Washington, and Wisconsin). Potentially preventable hospitalizations were measured using the AHRQ algorithm for any of the following chronic condition Prevention Quality Indicators (PQIs): uncontrolled diabetes (PQI 14), diabetes related short-term and long-term complications (PQI 1, PQI 3); chronic obstructive pulmonary disease or asthma (PQI 5 and PQI 15), hypertension (PQI 7), and heart failure (PQI 8). The 4th quarter indicator attempts to capture the possible trend shift due to the implementation of ICD10 codes in October 2015. ICD9 codes were used for discharges in quarter 1–quarter 3 and ICD10 for quarter 4 in 2015. Boldface indicates statistical significance (p<0.05).
Sources: 2015 HCUP SID, 2015 AHA annual survey, and the 2015 AHA Care Systems and Payment Survey.
ACO, accountable care organization; NH, Non-Hispanic; AHRQ, Agency for Healthcare Research and Quality; HCUP, Healthcare Cost and Utilization Project; SID, State Inpatient Databases; AHA, American Hospital Association.