Table 2.
Patient, Hospital, and Community Factors Associated with an ACSC ED visit to High ACSC Hospitals
| High ACSC Hospital aOR [95% CI] |
High Chronic ACSC Hospital aOR [95% CI] |
High Acute ACSC Hospital aOR [95% CI] |
|
|---|---|---|---|
| Patient Characteristics | |||
| Age | |||
| 65–74 | Ref | Ref | Ref |
| 75–84 | 0.99 [0.98, 0.99]*** | 0.96 [0.95, 0.96]*** | 1.03 [1.02, 1.03]*** |
| 85 + | 0.95 [0.94, 0.96] *** | 0.89 [0.89, 0.90]*** | 1.06 [1.05, 1.07]*** |
| Female | 1.02 [1.02, 1.03]*** | 0.99 [0.99, 1.00]** | 1.04 [1.03, 1.04]*** |
| Race | |||
| White | Ref | Ref | Ref |
| Black | 1.37 [1.36, 1.38]*** | 1.61 [1.60, 1.62]*** | 0.81 [0.80, 0.82]*** |
| Other | 1.37 [1.36, 1.38]*** | 1.28 [1.27, 1.30]*** | 1.16 [1.15, 1.17]*** |
| Elixhauser comorbidity index | |||
| 0–1 | Ref | Ref | Ref |
| 2 | 1.17 [1.16, 1.17]*** | 1.22 [1.21, 1.24]*** | 1.04 [1.04, 1.05]*** |
| 3 + | 1.26 [1.26, 1.27]*** | 1.39 [1.38, 1.40]*** | 1.04 [1.03, 1.05]*** |
| Dual-eligible | 1.18 [1.18, 1.19]*** | 1.20 [1.19, 1.20]*** | 1.11 [1.10, 1.11]*** |
| Hospital Characteristics | |||
| Teaching Hospital | |||
| None | Ref | ref | Ref |
| Minor teaching hospital | 0.27 [0.26, 0.27]*** | 0.56 [0.56, 0.57]*** | 0.30 [0.30, 0.30]*** |
| Major teaching hospital | 1.09 [1.08, 1.10]*** | 1.22 [1.21, 1.23]*** | 1.13 [1.13, 1.14]*** |
| Community Characteristics | |||
| Region | |||
| Northeast | Ref | Ref | Ref |
| Midwest | 0.49 [0.49, 0.49]*** | 0.43 [0.43, 0.43]*** | 0.71 [0.70, 0.71]*** |
| South | 0.38 [0.38, 0.39]*** | 0.35 [0.34, 0.35]*** | 0.54 [0.54, 0.55]*** |
| West | 0.17 [0. 17, 0. 17]*** | 0.12 [0.12, 0.12]*** | 0.45 [0.45, 0.46]*** |
| Urbanicity | |||
| Large central metro | Ref | Ref | Ref |
| Large fringe metro | 1.58 [1.57, 1.59]*** | 1.14 [1.13, 1.15]*** | 1.62 [1.61, 1.63]*** |
| Medium/small metro | 0.41 [0.41, 0.41]*** | 0.35 [0.35, 0.36]*** | 0.77 [0.77, 0.78]*** |
| Micro/non-metropolitan | 0.39 [0.38, 0.39]*** | 0.32 [0.32, 0.33]*** | 0.75 [0.74, 0.75]*** |
| Hospital Community Characteristics | |||
| % Poverty | 1.003 [1.001, 1.004]*** | 1.08 [1.08, 1.08]*** | 1.00 [1.00, 1.00] |
| Median household income | 0.95 [0.95, 0.95]*** | 0.95 [0.95, 0.95]*** | 1.00 [1.00, 1.00]*** |
| Didn’t see doctor because of cost | 1.00 [1.00, 1.00]*** | 1.02 [1.02, 1.02]*** | 0.99 [0.99, 0.99]*** |
| High housing costs | 0.96 [0.96, 0.96]*** | 1.00 [1.00, 1.00]*** | 0.94 [0.93, 0.94]*** |
| High school education or higher | 0.93 [0.93, 0.94]*** | 1.01 [1.00, 1.01]*** | 0.94 [0.94, 0.95]*** |
| Food insecurity | 0.98 [0.97, 0.98]*** | 0.93 [0.93, 0.93]*** | 1.01 [1.01, 1.01]*** |
| Federally qualified health center/100 K | 0.98 [0.98, 0.98]*** | 0.98 [0.98, 0.98]*** | 0.99 [0.99, 0.99]*** |
| Primary care / 100 K | 1.00 [1.00, 1.00]*** | 1.00 [1.00, 1.00]*** | 1.00 [1.00, 1.00]*** |
| Percent population by race | |||
| % White | 1.00 [1.00, 1.00]** | 1.00 [1.00, 1.01] *** | 1.00 [1.00, 1.00]*** |
| % Black | 1.01 [1.01, 1.01]*** | 1.02 [1.01, 1.02]*** | 1.01 [1.01, 1.01]*** |
| % Hispanic | 1.00 [1.00, 1.01]*** | 1.01 [1.00, 1.01]*** | 1.01 [1.01, 1.01]*** |
***p < 0.001, **p < 0.01, *p < 0.05
Notes. “ED” emergency department, “ACSCs” ambulatory care sensitive conditions
Results from logistic regression models with robust standard errors, where the outcome is whether the ACSC visit was to a hospital with a high proportion of ACSCs, a high proportion of chronic ACSCs, or a high proportion of acute ACSCs