Table 2.
Associated factors of hospital CVD deaths from NMSS in China, 2008-2020: estimated from multilevel logistics regression
| Factors | Model 1 OR (95%CI) | Model 2 OR (95%CI) | Model 3 OR (95%CI) | Model 4 OR (95%CI) | Model 5 OR (95%CI) | Model 6 OR (95%CI) |
|---|---|---|---|---|---|---|
| Fixed effect | ||||||
| Constant | 0·20 (0·16-0·26) * | 0·32 (0·25-0·40) * | 0·17 (0·14-0·21) * | 0·15 (0·12-0·18) * | 0·14 (0·10-0·19) * | 0·14 (0·10-0·20) * |
| Year (2008-2020) | – | 0·99 (0·99-1·00) * | 0·99 (0·98-1·00) * | 0·99 (0·99-0·99) * | 0·99 (0·99-1·00) * | 0·99 (0·98-1·00) * |
| NMSS expansion (Reference: Before 2013) | ||||||
| After 2013 | – | 1·14 (1·13-1·15) * | 1·20 (1·19-1·21) * | 1·20 (1·19-1·21) * | 1·22 (1·20-1·23) * | 1·22 (1·21-1·24) * |
| Location (Reference: Rural) | ||||||
| Urban | – | 2·40 (2·38-2·41) * | 1·24 (1·24-1·25) * | 1·24 (1·23-1·25) * | 1·24 (1·23-1·25) * | 1·24 (1·23-1·25) * |
| Sex (Reference: Male) | ||||||
| Female | – | 0·94 (0·94-0·95) * | 1·08 (1·07-1·08) * | 1·08 (1·07-1·08) * | 1·08 (1·07-1·08) * | 1·08 (1·07-1·08) * |
| Age groups, years old (Reference: 0-14) | ||||||
| 15-64 | – | 0·18 (0·17-0·19) * | 0·40 (0·37-0·43) * | 0·46 (0·43-0·50) * | 0·46 (0·43-0·49) * | 0·46 (0·43-0·49) * |
| 65-84 | – | 0·12 (0·11-0·13) * | 0·27 (0·25-0·29) * | 0·31 (0·29-0·33) * | 0·31 (0·29-0·33) * | 0·31 (0·29-0·33) * |
| 85 and above | – | 0·10 (0·09-0·11) * | 0·22 (0·20-0·23) * | 0·25 (0·24-0·27) * | 0·25 (0·24-0·27) * | 0·25 (0·24-0·27) * |
| Ethnicity (Reference: Han) | ||||||
| Other ethnics | – | 0·72 (0·71-0·73) * | 0·74 (0·73-0·75) * | 0·74 (0·74-0·75) * | 0·74 (0·73-0·75) * | 0·74 (0·73-0·75) * |
| Marital Status (Reference: Married) | ||||||
| Unmarried | – | 0·79 (0·78-0·80) * | 0·90 (0·89-0·91) * | 0·90 (0·89-0·91) * | 0·90 (0·89-0·91) * | 0·90 (0·89-0·91) * |
| Widowed/Divorced | – | 0·57 (0·57-0·57) * | 0·58 (0·58-0·59) * | 0·59 (0·58-0·59) * | 0·59 (0·58-0·59) * | 0·59 (0·58-0·59) * |
| Unknown | – | 0·78 (0·76-0·79) * | 0·72 (0·71-0·74) * | 0·73 (0·71-0·74) * | 0·73 (0·71-0·74) * | 0·73 (0·71-0·75) * |
| Education (Reference: Junior high school and below) | ||||||
| Senior high school | – | – | 1·57 (1·56-1·58) * | 1·56 (1·55-1·57) * | 1·56 (1·55-1·57) * | 1·56 (1·55-1·57) * |
| College and above | – | – | 1·94 (1·92-1·97) * | 1·92 (1·90-1·95) * | 1·92 (1·90-1·95) * | 1·92 (1·89-1·95) * |
| Occupation (Reference: Agricultural-related personnel) | ||||||
| Retired | – | – | 5·66 (5·62-5·70) * | 5·62 (5·58-5·66) * | 5·62 (5·58-5·66) * | 5·57 (5·53-5·61) * |
| Unemployment/Student | – | – | 3·21 (3·19-3·24) * | 3·19 (3·17-3·22) * | 3·19 (3·17-3·22) * | 3·21 (3·18-3·23) * |
| Worker/Self-employed/Enterprise manager | – | – | 4·20 (4·16-4·23) * | 4·16 (4·12-4·20) * | 4·16 (4·12-4·20) * | 4·20 (4·17-4·24) * |
| Professional/Staff/Civil servant | – | – | 4·85 (4·79-4·92) * | 4·81 (4·74-4·87) * | 4·81 (4·74-4·87) * | 4·87 (4·81-4·93) * |
| Others/Unknown | – | – | 3·81 (3·78-3·84) * | 3·78 (3·75-3·81) * | 3·79 (3·76-3·82) * | 3·79 (3·75-3·82) * |
| Underlying cause of death (Reference: Rheumatic heart disease) | ||||||
| Hypertensive heart disease | – | – | – | 0·63 (0·62-0·64) * | 0·63 (0·62-0·64) * | 0·63 (0·62-0·65) * |
| Ischemic heart disease | – | – | – | 0·85 (0·84-0·87) * | 0·85 (0·84-0·87) * | 0·85 (0·84-0·87) * |
| Stroke | – | – | – | 0·82 (0·80-0·83) * | 0·82 (0·80-0·83) * | 0·82 (0·80-0·83) * |
| Myocarditis and myocardial disease | – | – | – | 1·17 (1·11-1·23) * | 1·16 (1·11-1·23) * | 1·16 (1·10-1·22) * |
| Aortic aneurysm | – | – | – | 7·02 (6·72-7·34) * | 7·03 (6·73-7·34) * | 7·05 (6·75-7·37) * |
| Other cardiovascular diseases | – | – | – | 0·98 (0·96-1·00) * | 0·98 (0·96-1·00) * | 0·98 (0·96-1·00) * |
| Region (Reference: Western) | ||||||
| Central | – | – | – | – | 1·26 (0·73-2·20) | 1·26 (0·74-2·17) |
| Eastern | – | – | – | – | 0·99 (0·60-1·65) | 0·97 (0·59-1·59) |
| GDP, 10 000 yuan per person (Reference: Q1, <2·55) | ||||||
| Q2 (2·55-3.22) | – | – | – | – | 1·12 (1·11-1·14) * | 1·14 (1·12-1·15) * |
| Q3 (3.23-4.52) | – | – | – | – | 1·11 (1·09-1·13) * | 1·14 (1·12-1·16) * |
| Q4 (>=4.53) | – | – | – | – | 1·06 (1·03-1·08) * | 1·09 (1·07-1·11) * |
| Average years of education attainment, years (Reference: Q1, <8·42) | ||||||
| Q2 (8·42-8·99) | – | – | – | – | 0·96 (0·95-0·97) * | 0·96 (0·95-0·97) * |
| Q3 (9·00-9·46) | – | – | – | – | 0·96 (0·94-0·97) * | 0·96 (0·95-0·98) * |
| Q4 (>=9·46) | – | – | – | – | 0·95 (0·93-0·97) * | 0·96 (0·94-0·98) * |
| Number of beds in healthcare institutions, units per 100 000 persons (References: Q1, <3·89) | ||||||
| Q2 (3·89-4·83) | – | – | – | – | 0·97 (0·95-0·98) * | 0·97 (0·96-0·98) * |
| Q3 (4·84-5·85) | – | – | – | – | 0·90 (0·89-0·92) * | 0·91 (0·89-0·92) * |
| Q4 (>=5·85) | – | – | – | – | 0·95 (0·93-0·97) * | 0·96 (0·94-0·98) * |
| GDP × Junior high school and below (Reference) | ||||||
| GDP × Senior high school | – | – | – | – | – | 1·00 (0·99-1·00) * |
| GDP × College and above | – | – | – | – | – | 1·01 (1·00-1·01) * |
| GDP × Agricultural-related personnel (Reference) | ||||||
| GDP × Retired | – | – | – | – | – | 1·02 (1·02-1·03) * |
| GDP × Unemployment/Student | – | – | – | – | – | 0·99 (0·98-1·00) * |
| GDP × Worker/Self-employed/Enterprise manager | – | – | – | – | – | 1·01 (1·00-1·01) * |
| GDP × Professional/Staff/Civil servant | – | – | – | – | – | 1·03 (1·02-1·03) * |
| GDP × Others/Unknown | – | – | – | – | – | 1·01 (1·01-1·02) * |
| Random effects | ||||||
| Variance among provinces (SE) | 0·50 (0·13) | 0·42 (0·11) | 0·33 (0·09) | 0·33 (0·09) | 0·35 (0·09) | 0·33 (0·09) |
| MOR | 1·96 | 1·85 | 1·73 | 1·73 | 1·76 | 1·74 |
| PCV (%) | 16·61 | 33·88 | 33·32 | 29·95 | 32·80 | |
Abbreviations: OR, odds ratio; CI, confidence interval; Q1, 1st quantile; Q2, 2nd quantile; Q3, 3rd quantile; Q4, 4th quantile; SE, standard error; MOR, median odds ratio; PCV, Proportional change in variance
aP<0·05.
bRegion: Western: Inner Mongolia, Guangxi, Chongqing, Sichuan, Guizhou, Yunnan, Tibet, Shaanxi, Gansu, Qinghai, Ningxia, Xinjiang; Central: Shanxi, Jilin, Heilongjiang, Anhui, Jiangxi, Henan, Hubei, Hunan; Eastern: Beijing, Tianjin, Hebei, Liaoning, Shanghai, Jiangsu, Zhejiang, Fujian, Shandong, Guangdong, Hainan.