Disparities in length of stay for hip fracture treatment between patients treated in safety-net and non-safety-net hospitals

Coffield, Edward; Thirunavukkarasu, Saeyoan; Ho, Emily; Munnangi, Swapna; Angus, L.D. George

doi:10.1186/s12913-020-4896-1

Table 4 Negative binomial regression model: Association between length of stay, hospital type,^a and other factors among respondents aged 70 years and older^b

From: Disparities in length of stay for hip fracture treatment between patients treated in safety-net and non-safety-net hospitals

	Coefficient	Std. Error	p-value	95% CI	% change
Demographics
Gender (Referent: Male)
Female	−0.06	0.01	0.00	[−0.07, − 0.04]	− 5.7
Race (Referent: White)
Black/African American	0.18	0.05	0.00	[0.08, 0.27]	19.2
Other	0.03	0.03	0.22	[−0.02, 0.08]	3.1
Ethnicity (Referent: Non-Spanish/Hispanic)
Spanish/Hispanic	0.03	0.03	0.34	[−0.03, 0.1]	3.3
Multiple ethnicities	0.07	0.10	0.53	[−0.14, 0.27]	6.7
Unknown	−0.01	0.04	0.86	[−0.09, 0.07]	−0.7
Clinical Indicator
Type of admission (Referent: Other^c)
Emergency, Trauma, Urgent	−0.51	0.07	0.00	[−0.64, − 0.39]	−40.1
APR-DRG severity of Illness (Referent: Minor)
Moderate	0.08	0.01	0.00	[0.07, 0.09]	8.3
Major	0.21	0.01	0.00	[0.18, 0.23]	22.9
Extreme	0.64	0.03	0.00	[0.58, 0.69]	89
APR-DRG risk of mortality (Referent: Minor)
Moderate	0.10	0.01	0.00	[0.09, 0.12]	10.8
Major	0.31	0.01	0.00	[0.28, 0.33]	36.2
Extreme	0.53	0.03	0.00	[0.48, 0.59]	70.6
Hospital Indicators
Safety-net hospital status (SNH) (Referent: No)
Yes	0.10	0.04	0.01	[0.03, 0.18]	10.9
Health insurance type (Referent: Commerical^d)
Medicaid	0.17	0.05	0.00	[0.08, 0.27]	18.6
Medicare	−0.04	0.03	0.10	[− 0.09, 0.01]	−4.1
Dual-eligible (Medicaid/Medicare)	−0.03	0.03	0.31	[−0.1, 0.03]	−3.3
Self-pay	−0.06	0.06	0.35	[−0.17, 0.06]	−5.4
Other/unknown^e	0.07	0.05	0.16	[−0.03, 0.17]	7.5
Disposition (Referent: Home^f)
Expired	−0.42	0.03	0.00	[−0.48, − 0.35]	−34.1
Inpatient rehabilitation facility	−0.13	0.04	0.00	[−0.2, − 0.05]	−11.9
Nursing home/long term care^g	−0.10	0.07	0.15	[−0.24, 0.04]	−9.6
Skilled nursing facility	−0.09	0.02	0.00	[−0.14, − 0.05]	−8.9
Other^h	−0.36	0.04	0.00	[−0.43, − 0.28]	−29.9
N	40,039

Note. a. hospital type includes safety-net hospitals and non-safety-net hospitals where safety-net hospitals were defined as hospitals with a payer mix consisting of at least 30% of Medicaid and uninsured payers. b. illustrated statistics are coefficients and percent change amounts calculated through negative binomial regression models; the sample consisted of hip fracture patients from the SPARCS database with full covariate information; standard errors and 95% confidence intervals for the coefficients are also reported. c. other admission types of include: elective, newborn, and not available. d. commercial insurance includes: Blue Cross/Blue Shield; managed care, unspecific; and private health insurance. e. other insurance includes: Department of Corrections; federal/state/local/VA; other/miscellaneous; and unknown. f. patient discharged to: home or self-care; home with home health service; hospice (home); or left against medical advice. g. Medicaid Certified Nursing Home; Medicare Certified Long Term Care facility. h. patient discharged to: another facility not listed; cancer center or children’s hospital; court/law enforcement; critical access hospital; facility with custodial/supportive care; federal health care facility; hospital-based Medicare approved swing bed; hospice-medical facility; psychiatric hospital; short-term hospital

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