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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.
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