Table 5 –
Odds Ratios for Inpatient Safety Measures by Race/Ethnicity Obtained From Multiple Logistic Regression Analyses
| Prolonged LOS1 (OR, 95% CI) |
Inpatient
Medical Complications2 (OR, 95% CI) |
Inpatient
Surgical Complications3 (OR, 95% CI) |
|
|---|---|---|---|
| Model 1: Race alone | |||
| White | Reference | Reference | Reference |
| Black | 1.66 (1.47–1.89) | 1.32 (1.14–1.54) | 0.97 (0.8–1.18) |
| Hispanic | 1.28 (1.05–1.57) | 1.14 (0.92–1.42) | 1.31 (1.05–1.64) |
| Other | 1.37 (1.13–1.67) | 1.05 (0.82–1.33) | 1.03 (0.78–1.37) |
| Model 2: Model 1 + fusion procedure | |||
| White | Reference | Reference | Reference |
| Black | 1.66 (1.47–1.89) | 1.33 (1.14–1.55) | 0.97 (0.81–1.18) |
| Hispanic | 1.28 (1.05–1.57) | 1.14 (0.91–1.42) | 1.32 (1.06–1.65) |
| Other | 1.38 (1.13–1.67) | 1.04 (0.81–1.32) | 1.03 (0.78–1.37) |
| Model 3: Model 2 + age, sex, comorbidities | |||
| White | Reference | Reference | Reference |
| Black | 1.6 (1.4–1.83) | 1.27 (1.08–1.49) | 0.97 (0.8–1.18) |
| Hispanic | 1.33 (1.09–1.62) | 1.21 (0.97–1.5) | 1.37 (1.09–1.71) |
| Other | 1.53 (1.25–1.86) | 1.18 (0.92–1.51) | 1.08 (0.82–1.43) |
| Model 4: Model 3 + hospital factors4 | |||
| White | Reference | Reference | Reference |
| Black | 1.45 (1.27–1.66) | 1.26 (1.07–1.48) | 0.97 (0.8–1.17) |
| Hispanic | 1.28 (1.05–1.57) | 1.11 (0.89–1.38) | 1.34 (1.06–1.68) |
| Other | 1.54 (1.27–1.86) | 1.19 (0.94–1.51) | 1.07 (0.81–1.41) |
| Model 5: Model 4 + SES factors5 | |||
| White | Reference | Reference | Reference |
| Black | 1.39 (1.22–1.59) | 1.24 (1.05–1.48) | 0.97 (0.8–1.17) |
| Hispanic | 1.24 (1.02–1.52) | 1.1 (0.88–1.38) | 1.34 (1.06–1.68) |
| Other | 1.5 (1.24–1.81) | 1.19 (0.93–1.5) | 1.06 (0.81–1.41) |
Prolonged LOS is defined as a hospital length of stay greater than the 90th percentile for the fusion procedure performed.
Inpatient medical complications included cardiovascular, pulmonary, or renal/urinary complications. We constructed a list of ICD-10-CM codes for each complication type (see Appendix C). To be a case, the patient’s hospital discharge needed to contain at least one complication code.
Inpatient surgical complications included hemorrhagic, infectious/wound, neurologic, and thromboembolic complications. We constructed a list of ICD-10-CM codes for each complication type (see Appendix C). To be a case, the patient’s hospital discharge needed to contain at least one complication code.
Regression model 4 corrects for the following hospital factors: hospital bedsize, location/teaching status, U.S. division, and fusion procedure volume.
Regression model 5 corrects for the following socioeconomic factors: payer/insurance and median household income for the patient’s zip code. White race is the reference group.
Total cost: Total charges for each hospital discharge were converted to total cost using hospital-specific cost-to-charge ratios, which are based on hospital accounting reports collected by the Centers for Medicare & Medicaid Services.