TABLE 3.
Adjusted Odds of Receiving Intense End-of-Life Care
| Category (Reference) | Hospital Death | Medically Intense | ≥2 Intensity Indicators | Inpatient Intravenous Chemotherapy | ||||
|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | |
| Death age (5–9 y) | ||||||||
| <5 y | 1.72 (1.36–2.17) | <.0001 | 1.42 (1.08–1.86) | .01 | 1.37 (1.05–1.78) | .02 | 1.03 (0.61–1.74) | .92 |
| 10–14 y | 1.03 (0.82–1.29) | .80 | 1.05 (0.80–1.39) | .71 | 1.07 (0.82–1.39) | .63 | 0.95 (0.56–1.59) | .83 |
| 15–21 y | 1.42 (1.16–1.73) | .0006 | 1.40 (1.11–1.77) | .01 | 1.29 (1.02–1.62) | .03 | 0.85 (0.54–1.36) | .51 |
| Insurance (HMO) | ||||||||
| Private insurance | 1.47 (1.17–1.83) | .0008 | 1.09 (0.84–1.42) | .52 | 1.08 (0.84–1.40) | .53 | 1.09 (0.65–1.80) | .95 |
| Public or self | 1.49 (1.20–1.84) | .0003 | 1.17 (0.91–1.50) | .22 | 1.07 (0.84–1.36) | .58 | 0.79 (0.48–1.30) | .22 |
| Sex (Male) | ||||||||
| Female | 1.22 (1.06–1.42) | .01 | 0.98 (0.83–1.16) | .84 | 1.00 (0.85–1.17) | .95 | 1.02 (0.72–1.43) | .93 |
| Race and/or ethnicity (non-Hispanic white) | ||||||||
| African American | 1.43 (1.05–1.94) | .02 | 1.29 (0.92–1.81) | .13 | 1.22 (0.88–1.70) | .23 | 0.82 (0.38–1.78) | .61 |
| Hispanic | 1.43 (1.20–1.70) | <.0001 | 1.23 (1.00–1.50) | .05 | 1.158 (0.97–1.44) | .09 | 0.99 (0.66–1.49) | .95 |
| Asian American | 1.32 (1.01–1.72) | .04 | 1.07 (0.79–1.45) | .67 | 0.95 (0.70–1.29) | .74 | 1.00 (0.54–1.85) | .99 |
| Other | 1.27 (0.88–1.85) | .20 | 1.18 (0.78–1.80) | .43 | 1.05 (0.69–1.59) | .83 | 0.81 (0.32–2.09) | .66 |
| Year of death (2000–2003) | ||||||||
| 2004–2007 | 1.03 (0.87–1.22) | .76 | 1.13 (0.93–1.38) | .21 | 1.09 (0.90–1.31) | .40 | 1.01 (0.68–1.50) | .97 |
| 2008–2011 | 1.15 (0.96–1.38) | .13 | 1.33 (1.09–1.63) | .01 | 1.29 (1.06–1.57) | .01 | 1.08 (0.71–1.64) | .72 |
| Diagnosis (solid tumors) | ||||||||
| Hematologic malignancies | 3.56 (3.04–4.17) | <.0001 | 2.31 (1.96–2.68) | <.0001 | 2.25 (1.92–2.65) | <.0001 | 2.21 (1.56–3.12) | <.0001 |
| No. chronic conditions (0 conditions) | ||||||||
| 1 chronic condition | 1.27 (1.07–1.51) | .01 | 0.89 (0.74–1.08) | .24 | 0.92 (0.76–1.10) | .35 | 0.85 (0.57–1.25) | .40 |
| ≥2 | 0.99 (0.69–1.42) | .95 | 0.84 (0.56–1.26) | .40 | 0.83 (0.56–1.24) | .37 | 0.51 (0.18–1.43) | .20 |
| Last hospital (specialty center) | ||||||||
| Nonspecialty center | 0.91 (0.75–1.09) | .29 | 1.34 (1.09–1.65) | .01 | 1.29 (1.05–1.57) | .01 | 0.56 (0.34–0.94) | .03 |
| Distance last hospital to home (<10 miles) | ||||||||
| 10–24.9 miles | 0.89 (0.73–1.05) | .14 | 0.81 (0.66–0.99) | .04 | 0.79 (0.65–0.96) | .02 | 0.79 (0.52–1.22) | .29 |
| ≥25 miles | 0.64 (0.53–0.78) | <.0001 | 0.88 (0.71–1.08) | .21 | 0.86 (0.70–1.05) | .13 | 0.88 (0.58–1.35) | .56 |
Also in the model, but nonsignificant: zip code–level income. CI, confidence interval; HMO, health maintenance organization; OR, odds ratio.