Table 2.
Associations between number of insomnia symptoms and odds of subsequent health services use: results from multivariable logistic regression analyses*
| Health services use unweighted n (%) | Model I† OR¶ (95% CI#) n = 4,239 | Model II‡ OR (95% CI) n = 4,191 | Model III§ OR (95% CI) n = 4,095 | Model IV|| OR (95% CI) n = 4,048 | |
|---|---|---|---|---|---|
| Emergency department visit | |||||
| 0 Insomnia symptoms | 915 (25.4) | Reference | Reference | Reference | Reference |
| 1 insomnia symptom | 280 (33.7) | 1.47 (1.18, 1.82)** | 1.29 (1.03, 1.63)* | 1.35 (1.07, 1.70)* | 1.23 (0.97, 1.57) |
| 2 insomnia symptoms | 220 (42.1) | 2.12 (1.69, 2.66)*** | 1.76 (1.39, 2.22)*** | 1.77 (1.37, 2.28)*** | 1.60 (1.24, 2.07)*** |
| All-cause hospitalization | |||||
| 0 Insomnia symptoms | 578 (16.4) | Reference | Reference | Reference | Reference |
| 1 insomnia symptom | 181 (21.7) | 1.39 (1.11, 1.73)** | 1.23 (0.97, 1.57) | 1.26 (1.01, 1.57)* | 1.19 (0.94, 1.50) |
| 2 insomnia symptoms | 142 (27.0) | 1.84 (1.48, 2.28)*** | 1.47 (1.16, 1.85)** | 1.45 (1.14, 1.83)** | 1.29 (1.01, 1.65)* |
| All-cause 30-day readmission | |||||
| 0 Insomnia symptoms | 82 (1.9) | Reference | Reference | Reference | Reference |
| 1 insomnia symptom | 28 (3.0) | 1.58 (0.97, 2.56) | 1.31 (0.80, 2.16) | 1.44 (0.85, 2.43) | 1.30 (0.77, 2.21) |
| 2 insomnia symptoms | 27 (5.7) | 2.89 (1.71, 4.87)*** | 2.03 (1.14, 3.64)* | 2.25 (1.34, 3.79) | 1.88 (1.08, 3.29)* |
| Home health care | |||||
| 0 Insomnia symptoms | 407 (9.8) | Reference | Reference | Reference | Reference |
| 1 insomnia symptom | 125 (12.9) | 1.27 (0.96, 1.70) | 1.05 (0.78, 1.42) | 1.09 (0.81, 1.48) | 0.96 (0.71, 1.30) |
| 2 insomnia symptoms | 107 (18.9) | 1.98 (1.42, 2.75)*** | 1.40 (0.99, 1.97) | 1.58 (1.11, 2.25)* | 1.26 (0.88, 1.80) |
*NHATS 2011; N = 4,289; community-dwelling older adults continuously enrolled in Medicare FFS for 365 days or who died within 365 days from the interview date. Responses of “every night” or “most nights” were categorized to indicate the presence of insomnia symptoms.
†Model I adjusted for demographic characteristics (age, sex, race/ethnicity, education).
‡Model II adjusted for Model I covariates + mental health characteristics (depressive and anxiety symptoms).
§Model III adjusted for Model I covariates + physical health characteristics (BMI, number of medical conditions).
||Model IV fully adjusted for demographic, mental health, and physical health characteristics.
¶OR = odds ratio.
#CI = confidence interval.
*p < 0.05, **p < 0.01, ***p < 0.001.