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Table 3 Multinomial regression models for factors associated with frequent emergency department visits for acute exacerbation of chronic obstructive pulmonary disease, stratified by state

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

  California Florida
  2 (vs. 1) ED visits ≥ 3 (vs. 1) ED visits 2 (vs. 1) ED visits ≥ 3 (vs. 1) ED visits
Variables Odds ratio (95% CI) P value Odds ratio (95% CI) P value Odds ratio (95% CI) P value Odds ratio (95% CI) P value
Age, y         
 40-54 years 1 [reference]   1 [reference]   1 [reference]   1 [reference]  
 55-64 years 1.20 (1.11-1.31) <0.001 1.32 (1.21-1.45) <0.001 1.11 (1.03-1.21) 0.008 1.28 (1.17-1.41) <0.001
 65-74 years 1.17 (1.07-1.29) 0.001 1.16 (1.04-1.29) 0.008 1.13 (1.03-1.23) 0.01 1.05 (0.95-1.17) 0.34
 75-84 years 1.15 (1.04-1.27) 0.007 0.90 (0.80-1.01) 0.08 0.98 (0.89-1.08) 0.73 1.81 (0.73-0.91) <0.001
 85 years and older 0.99 (0.88-1.11) 0.83 0.61 (0.53-0.70) <0.001 0.85 (0.76-0.96) 0.007 0.54 (0.47-0.63) <0.001
Male sex 1.05 (1.00-1.10) 0.048 1.13 (1.06-1.19) <0.001 1.03 (0.98-1.08) 0.30 1.11 (1.05-1.18) <0.001
Race/ethnicity         
 Non-hispanic white 1.15 (1.06-1.25) 0.001 1.32 (1.20-1.46) <0.001 1.13 (1.03-1.23) 0.004 1.30 (1.17-1.44) <0.001
 Non-hispanic black 1.24 (1.11-1.38) 0.001 1.71 (1.51-1.93) <0.001 1.12 (1.01-1.25) 0.04 1.49 (1.31-1.69) <0.001
 Hispanic 1 [reference]   1 [reference]   1 [reference]   1 [reference]  
 Other 1.23 (1.00-1.28) 0.06 1.16 (0.99-1.35) 0.06 0.85 (0.65-1.10) 0.21 0.80 (0.57-1.12) 0.20
Insurance status         
 Medicare 1.55 (1.41-1.71) <0.001 1.88 (1.67-2.11) <0.001 1.63 (1.47-1.81) <0.001 2.41 (2.11-2.75) <0.001
 Medicaid 1.65 (1.48-1.83) <0.001 2.58 (2.29-2.92) <0.001 1.96 (1.75-2.20) <0.001 3.38 (2.93-3.89) <0.001
 Private 1 [reference]   1 [reference]   1 [reference]   1 [reference]  
 Self-pay 1.10 (0.95-1.28) 0.21 1.05 (0.87-1.27) 0.62 1.13 (0.98-1.29) 0.09 1.11 (0.92-1.33) 0.29
 Other 1.34 (1.14-1.57) <0.001 1.34 (1.10-1.62) 0.004 1.58 (1.37-1.81) <0.001 2.25 (1.90-2.67) <0.001
Quartiles for median household income of patient’s ZIP code
 1 (lowest) 1.24 (1.13-1.37) <0.001 1.18 (1.09-1.28) <0.001 1.10 (1.01-1.19) 0.03 1.22 (1.11-1.34) <0.001
 2 1.22 (1.12-1.32) <0.001 1.24 (1.13-1.37) <0.001 1.03 (0.95-1.11) 0.49 1.19 (1.08-1.31) <0.001
 3 1.12 (1.03-1.21) 0.001 1.20 (1.09-1.33) <0.001 1.04 (0.95-1.13) 0.40 1.07 (0.97-1.19) 0.19
 4 (highest) 1 [reference]   1 [reference]   1 [reference]   1 [reference]  
Patient residence         
 Counties of ≥ 1 million population 1.00 (0.89-1.12) 0.99 0.97 (0.86-1.11) 0.69 1.10 (1.01-1.20) 0.03 1.16 (1.04-1.28) 0.005
 Counties of 250,000-999,999 population 1.06 (0.94-1.20) 0.34 1.02 (0.89-1.17) 0.78 1.07 (0.98-1.17) 0.16 1.09 (0.98-1.22) 0.10
 Counties of 50,000-249,999 population 1.01 (0.87-1.06) 0.92 1.04 (0.89-1.22) 0.65 1.16 (1.02-1.32) 0.02 1.10 (0.94-1.28) 0.23
 Counties of < 50,000 population 1 [reference]   1 [reference]   1 [reference]   1 [reference]  
Selected comorbidities         
 Congestive heart failure 1.16 (1.09-1.23) <0.001 1.27 (1.18-1.36) <0.001 1.18 (1.11-1.26) <0.001 1.22 (1.13-1.31) <0.001
 Pulmonary circulation disorders 1.51 (1.22-1.86) <0.001 1.34 (1.04-1.73) 0.02 1.29 (1.05-1.60) 0.02 1.37 (1.09-1.73) 0.008
 Diabetes, uncomplicated 1.02 (0.96-1.09) 0.47 1.14 (1.06-1.23) <0.001 1.08 (1.02-1.15) 0.009 1.12 (1.05-1.20) <0.001
 Obesity 1.01 (0.92-1.10) 0.85 0.96 (0.87-1.06) 0.42 0.98 (0.91-1.06) 0.60 0.97 (0.89-1.06) 0.50
 Depression 1.22 (1.11-1.33) <0.001 1.39 (1.26-1.54) <0.001 1.19 (1.10-1.28) <0.001 1.37 (1.26-1.49) <0.001
 Psychoses 1.19 (1.07-1.32) 0.001 1.26 (1.13-1.42) <0.001 1.16 (1.04-1.29) 0.01 1.28 (1.14-1.45) <0.001
 Drug abuse 1.27 (1.10-1.47) 0.001 1.72 (1.49-1.97) <0.001 1.16 (0.97-1.39) 0.10 1.55 (1.30-1.86) <0.001
  1. Abbreviations: COPD chronic obstructive pulmonary disease, ED emergency department, CI confidence interval.
  2. Bold results are statistically significant.