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Table 2 Multinomial regression models for factors associated with frequent emergency department visits for acute exacerbation of chronic obstructive pulmonary disease

From: Frequent utilization of the emergency department for acute exacerbation of chronic obstructive pulmonary disease

 

2 (vs. 1) ED visits

≥ 3 (vs. 1) ED visits

Variables

Odds ratio (95% CI)

P value

Odds ratio (95% CI)

P value

Age, y

 

<0.001

 

<0.001

 40-54 years

1 [reference]

 

1 [reference]

 

 55-64 years

1.15 (1.09-1.22)

<0.001

1.31 (1.23-1.39)

<0.001

 65-74 years

1.14 (1.07-1.22)

<0.001

1.11 (1.03-1.20)

0.006

 75-84 years

1.05 (0.98-1.12)

0.10

0.86 (0.79-0.93)

<0.001

 85 years and older

0.90 (0.83-0.97)

0.03

0.58 (0.52-0.64)

<0.001

Male sex

1.04 (1.00-1.08)

0.048

1.12 (1.07-1.17)

<0.001

Race/ethnicity

    

 Non-hispanic white

1.15 (1.08-1.21)

<0.001

1.32 (1.23-1.41)

<0.001

 Non-hispanic black

1.17 (1.09-1.27)

<0.001

1.59 (1.46-1.73)

<0.001

 Hispanic

1 [reference]

 

1 [reference]

 

 Other

1.07 (0.96-1.19)

0.29

1.07 (0.96-1.19)

0.33

Insurance status

    

 Medicare

1.58 (1.47-1.69)

<0.001

2.10 (1.92-2.29)

<0.001

 Medicaid

1.77 (1.64-1.92)

<0.001

2.92 (2.66-3.20)

<0.001

 Private

1 [reference]

 

1 [reference]

 

 Self-pay

1.11 (1.00-1.23)

0.046

1.05 (0.92-1.20)

0.45

 Other

1.46 (1.32-1.62)

<0.001

1.78 (1.57-2.02)

<0.001

Quartiles for median household income of patient’s ZIP code

  

 1 (lowest)

1.13 (1.07-1.20)

<0.001

1.29 (1.21-1.38)

<0.001

 2

1.11 (1.05-1.18)

<0.001

1.22 (1.14-1.31)

<0.001

 3

1.08 (1.01-1.14)

0.01

1.14 (1.06-1.22)

<0.001

 4 (highest)

1 [reference]

 

1 [reference]

 

Patient residence

    

 Counties of ≥ 1 million population

1.07 (1.00-1.15)

0.06

1.09 (1.01-1.18)

0.03

 Counties of 250,000-999,999 population

1.07 (1.00-1.15)

0.07

1.09 (1.00-1.18)

0.06

 Counties of 50,000-249,999 population

1.09 (1.00-1.20)

0.06

1.10 (0.99-1.23)

0.09

 Counties of < 50,000 population

1 [reference]

 

1 [reference]

 

State

    

 California

1.01 (0.98-1.05)

0.44

1.06 (1.02-1.11)

0.006

 Florida

1 [reference]

 

1 [reference]

 

Selected comorbidities*

    

 Congestive heart failure

1.17 (1.11-1.22)

<0.001

1.24 (1.17-1.30)

<0.001

 Pulmonary circulation disorders

1.41 (1.22-1.64)

<0.001

1.39 (1.17-1.64)

<0.001

 Diabetes, uncomplicated

1.05 (1.01-1.10)

0.02

1.13 (1.07-1.19)

<0.001

 Obesity

0.99 (0.94-1.05)

0.79

0.97 (0.91-1.03)

0.31

 Depression

1.21 (1.14-1.28)

<0.001

1.38 (1.30-1.47)

<0.001

 Psychoses

1.17 (1.09-1.27)

<0.001

1.27 (1.17-1.38)

<0.001

 Drug abuse

1.22 (1.09-1.37)

<0.001

1.66 (1.48-1.85)

<0.001

  1. Abbreviations: COPD chronic obstructive pulmonary disease, ED emergency department, CI confidence interval.
  2. Bold results are statistically significant.
  3. *Non-significant Elixhauser comorbidity measures across the frequency groups included peripheral vascular disease, hypertension, neurological disorders, diabetes with complications, liver disease, peptic ulcer disease, acquired immunodeficiency syndrome, lymphoma, solid tumor without metastasis, coagulopathy, fluid and electrolyte disorders, anemia, and alcohol abuse.