Table 2.
Logistic Regression Assessing Factors Associated with Health Care Utilization Among Johns Hopkins Patients Between 2016–2018*
| Variables | Overall population |
Medicaid population |
||||
|---|---|---|---|---|---|---|
| OR† | 95% CI | P | OR† | 95% CI | P | |
| Housing Issues | ||||||
| Homelessness | 1.336 | 1.261–1.416 | <0.00001 | 1.902 | 1.576–2.296 | <0.00001 |
| Housing Instability | 1.489 | 1.380–1.607 | <0.00001 | 1.473 | 1.227–1.769 | <0.00001 |
| Characteristics of the Building | 0.888 | 0.818–0.964 | 0.00469 | 0.847 | 0.640–1.121 | 0.24500 |
| Age | ||||||
| 1.001 | 1.001–1.002 | <0.00001 | 1.010 | 1.008–1.011 | <0.00001 | |
| Sex (Male as reference) | ||||||
| Female | 1.437 | 1.409–1.467 | <0.00001 | 1.563 | 1.458–1.675 | <0.00001 |
| Race (White as reference) | ||||||
| Asian | 0.741 | 0.701–0.782 | <0.00001 | 0.493 | 0.385–0.631 | <0.00001 |
| African American | 0.959 | 0.937–0.981 | 0.00039 | 0.794 | 0.734–0.858 | <0.00001 |
| Others | 0.646 | 0.620–0.674 | <0.00001 | 0.553 | 0.488–0.627 | <0.00001 |
| Neighborhood Characteristics (ADI National Rank, neighborhoods below the 10th percentile as reference)‡ | ||||||
| Between 11th & 89th Percentiles | 1.442 | 1.404–1.481 | <0.00001 | 1.466 | 1.239–1.734 | <0.00001 |
| Above the 90th Percentile | 1.549 | 1.474–1.627 | <0.00001 | 1.598 | 1.325–1.926 | <0.00001 |
| Insurance Type (commercial insurance as reference) | ||||||
| Medicare | 1.489 | 1.447–1.532 | <0.00001 | - | - | - |
| Medicaid | 2.078 | 1.997–2.162 | <0.00001 | - | - | - |
| No insurance | 2.416 | 2.356–2.477 | <0.00001 | - | - | - |
| International | 1.909 | 1.358–2.683 | 0.00020 | - | - | - |
| Others | 0.394 | 0.301–0.516 | <0.00001 | - | - | - |
| Charlson Comorbidity Score (score of 0 as reference) | ||||||
| 1 | 5.636 | 5.503–5.771 | <0.00001 | 4.219 | 3.912–4.550 | <0.00001 |
| 2 | 18.674 | 18.100–19.267 | <0.00001 | 16.357 | 14.518–18.427 | <0.00001 |
| ≥3 | 55.444 | 53.333–57.639 | <0.00001 | 38.497 | 32.447–45.675 | <0.00001 |
| AIC§ | ||||||
| 312,925 | 27,005 | |||||
Health care utilization was defined as the number of encounters with the health care system during the study period (2016–2018). Logistic regression compared those at the 95th percentile (number of encounters ≥31) with the rest of the sample. Total sample size for overall the study population was 1,034,592 and for Medicaid patients was 76,946.
Odds ratios associated with being a top 5% user among study patients between 2016–2018.
Using ADI national rank for patient's place of residence. Higher ADI national rank represents a more disadvantaged neighborhood.
An estimator of the relative quality of statistical models for a given set of data. Lower values of AIC present a model with a better fit.
ADI, Area Deprivation Index; AIC, Akaike information criterion; CI, confidence enterval; OR, odds ratio; -, not applicable.