An analysis of equity in treatment of hip fractures for older patients with dementia in acute care hospitals: observational study using nationwide hospital claims data in Japan

Tomioka, Shinichi; Rosenberg, Megumi; Fushimi, Kiyohide; Matsuda, Shinya

doi:10.1186/s12913-020-05690-9

Table 3 Multivariate-adjusted coefficients and 95% CIs for waiting days for surgery with macro-level variance

From: An analysis of equity in treatment of hip fractures for older patients with dementia in acute care hospitals: observational study using nationwide hospital claims data in Japan

N = 159,173	model 1 (age, sex)				model 2 (Dementia level only)				model 3 (with clinical factors)				model 4 (with hospital factors)
	coef.	95% C.I.		P value	coef.	95% C.I.		P value	coef.	95% C.I.		P value	coef.	95% C.I.		P value
Compositional factor
Sex
Male (reference)
Female	−0.34	−0.38	−0.30	< 0.001					− 0.26	− 0.30	− 0.22	< 0.001	− 0.26	− 0.30	− 0.22	< 0.001
Age Group
65–79 (ref.)
80–89	−0.05	−0.09	−0.01	0.01					0.03	−0.01	0.07	0.10	0.03	−0.01	0.07	0.10
Over 90	−0.23	−0.28	− 0.19	< 0.001					−0.06	−0.11	− 0.01	0.02	− 0.06	−0.11	− 0.01	0.02
Dementia Level^a
No dementia (ref.)
Dementia level 1					0.02	−0.02	0.06	0.28	0.02	−0.02	0.06	0.34	0.02	−0.02	0.06	0.34
Dementia level 2					−0.06	− 0.10	−0.01	0.01	−0.08	− 0.12	− 0.03	0.002	−0.08	− 0.12	−0.03	0.002
Fx. Type
Femoral neck (ref.)
Trochanteric									−0.72	−0.75	−0.68	< 0.001	−0.72	− 0.75	− 0.68	< 0.001
Subtrochanteric									−0.56	− 0.72	− 0.40	< 0.001	− 0.56	− 0.72	− 0.40	< 0.001
Charlson Index
0 (ref.)
1									0.39	0.35	0.43	< 0.001	0.39	0.35	0.43	< 0.001
≥ 2									0.72	0.68	0.77	< 0.001	0.72	0.68	0.77	0.93
Coma Level^b
Alert (ref.)
Level 1									0.06	0.00	0.11	0.04	0.06	0.00	0.11	0.04
Level 2									0.26	0.00	0.51	0.05	0.26	0.00	0.51	0.05
Level 3									1.18	0.19	2.17	0.02	1.18	0.19	2.17	0.02
Ambulance Use
No ambulance use (ref.)
Ambulance use									0.16	0.12	0.19	< 0.001	0.16	0.12	0.19	< 0.001
Contextual factor
City level^c
Designated city (ref.)
Pop. ≥150,000													0.07	−0.21	0.34	0.62
Pop. 80,000≤, ≤150,000													−0.24	−0.58	0.10	0.16
Pop. ≤80,000													−0.27	−0.57	0.04	0.09
Hosp. function^d
Under 200 beds hosp.(ref.)
Over 200 beds hosp.													−0.40	−0.66	−0.14	0.003
Regional support hosp.													−0.66	−1.00	−0.31	< 0.001
University & advanced hosp.													−0.01	−0.50	0.47	0.96
Macro-level variance (S.E.)
between hospitals (n = 1170)	3.24	(0.15)			3.24	(0.15)			3.22	(0.15)			3.16	(0.15)

^aDementia level 1 and 2: represents “degree of independence in daily life for elderly people with dementia” criteria I-II and III-IV/M, respectively. ^bComa level refers to the Japan Coma Scale (JCS) which has four decisive levels of consciousness. ^cDesignated city has population over 500,000 and is designated by order of the Cabinet of Japan under Local Autonomy Law. ^dAdvanced hospitals include 6 national centers for cancer, circulation and global health. Regional support hospital has over 200 beds and meets requirements such as referral rate over 80% for outpatients

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ISSN: 1472-6963

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