Table 3. Associations of Guideline-Based Care and In-Hospital or 30-Day Outcomes With Dual-Eligible Quintiles.
| Dual-eligible quintile | Unadjusted analysis | Adjusted analysis | ||
|---|---|---|---|---|
| OR (95% CI) | P value | OR (95% CI) | P value | |
| Achievement measures | ||||
| ACEI, ARB, or ARNI at discharge | ||||
| Quintile 5 | 0.88 (0.60-1.30) | .52 | 0.85 (0.57-1.27) | .41 |
| Quintile 4 | 1.10 (0.79-1.52) | .58 | 1.05 (0.76-1.45) | .77 |
| Quintile 3 | 0.94 (0.69-1.28) | .71 | 0.96 (0.69-1.33) | .80 |
| Quintile 2 | 1.04 (0.75-1.46) | .80 | 0.99 (0.71-1.37) | .93 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
| Evidence-based specific β-blockers | ||||
| Quintile 5 | 0.80 (0.58-1.11) | .18 | 0.70 (0.52-0.94) | .02 |
| Quintile 4 | 0.84 (0.64-1.12) | .24 | 0.79 (0.61-1.02) | .07 |
| Quintile 3 | 0.86 (0.64-1.17) | .34 | 0.78 (0.58-1.04) | .09 |
| Quintile 2 | 0.80 (0.58-1.10) | .17 | 0.78 (0.60-1.02) | .07 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
| Measure LV function | ||||
| Quintile 5 | 0.40 (0.20-0.79) | .009 | 0.39 (0.21-0.72) | .002 |
| Quintile 4 | 0.88 (0.55-1.39) | .58 | 0.81 (0.51-1.29) | .38 |
| Quintile 3 | 0.72 (0.44-1.18) | .19 | 0.61 (0.37-0.99) | .04 |
| Quintile 2 | 1.21 (0.75-1.97) | .43 | 1.00 (0.61-1.65) | .99 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
| Postdischarge appointment for patients with HF | ||||
| Quintile 5 | 0.70 (0.48-1.04) | .08 | 0.74 (0.51-1.08) | .11 |
| Quintile 4 | 0.75 (0.54-1.05) | .10 | 0.78 (0.56-1.08) | .13 |
| Quintile 3 | 0.61 (0.43-0.86) | .004 | 0.53 (0.38-0.74) | <.001 |
| Quintile 2 | 0.79 (0.59-1.06) | .12 | 0.72 (0.54-0.96) | .02 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
| HF defect-free care (100% adherence) | ||||
| Quintile 5 | 0.72 (0.54-0.98) | .03 | 0.80 (0.60-1.07) | .13 |
| Quintile 4 | 0.79 (0.59-1.06) | .11 | 0.84 (0.64-1.10) | .20 |
| Quintile 3 | 0.64 (0.48-0.85) | .002 | 0.60 (0.46-0.78) | <.001 |
| Quintile 2 | 0.83 (0.65-1.07) | .15 | 0.78 (0.62-0.99) | .04 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
| Outcomes | ||||
| In-hospital mortality | ||||
| Quintile 5 | 1.03 (0.87-1.21) | .74 | 1.13 (0.97-1.32) | .11 |
| Quintile 4 | 1.03 (0.89-1.19) | .69 | 1.03 (0.88-1.19) | .73 |
| Quintile 3 | 1.20 (1.03-1.40) | .02 | 1.26 (1.08-1.46) | .003 |
| Quintile 2 | 1.06 (0.90-1.25) | .49 | 1.07 (0.92-1.23) | .4009 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
| 30-d All-cause mortality | ||||
| Quintile 5 | 0.83 (0.73-0.93) | .001 | 1.01 (0.91-1.12) | .81 |
| Quintile 4 | 0.92 (0.85-0.99) | .03 | 1.00 (0.91-1.09) | .97 |
| Quintile 3 | 0.98 (0.91-1.07) | .71 | 1.05 (0.97-1.14) | .21 |
| Quintile 2 | 1.07 (0.99-1.16) | .10 | 1.11 (1.02-1.21) | .01 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
| 30-d All-cause readmission | ||||
| Quintile 5 | 1.30 (1.20-1.41) | <.001 | 1.24 (1.14-1.35) | <.001 |
| Quintile 4 | 1.18 (1.11-1.25) | <.001 | 1.14 (1.07-1.22) | <.001 |
| Quintile 3 | 1.09 (1.02-1.16) | .01 | 1.05 (0.99-1.12) | .12 |
| Quintile 2 | 1.03 (0.98-1.09) | .23 | 1.01 (0.95-1.07) | .85 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
| 30-d HF readmission | ||||
| Quintile 5 | 1.27 (1.15-1.41) | <.001 | 1.14 (1.03-1.27) | .01 |
| Quintile 4 | 1.24 (1.14-1.35) | <.001 | 1.15 (1.06-1.26) | .001 |
| Quintile 3 | 1.11 (1.02-1.20) | .02 | 1.04 (0.95-1.13) | .38 |
| Quintile 2 | 1.06 (0.98-1.14) | .12 | 1.01 (0.93-1.09) | .80 |
| Quintile 1 | 1 [Reference] | NA | 1 [Reference] | NA |
Abbreviations: ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor neprilysin inhibitor; HF, heart failure; LV, left ventricle; NA, not applicable; OR, odds ratio.