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Table 1 Participant characteristics at baseline and ambulatory care utilization in the subsequent 12 months, comparing those included (with ≥4 visits) to those excluded (with ≤3 visits)

From: Differences in ambulatory care fragmentation by race

Characteristic

Included

(≥4 visits)

N = 6799

Excluded

(≤3 visits)

N = 1745

P-value

Demographic characteristics

 Age, years, mean (SD)

73.0 (5.9)

72.0 (5.5)

< 0.0001

 Sex, female, N (%)

3573 (53)

734 (42)

< 0.0001

 Race, black, N (%)

2042 (30)

561 (32)

0.09

 Marital status, married, N (%)

3962 (58)

1064 (61)

0.04

 Annual household income, <$35,000, N (%)

3251 (48)

862 (49)

0.16

 Education, high school or less, N (%)

2779 (41)

691 (40)

0.40

 Geographic region, N (%)

  Stroke Belta

2428 (36)

641 (37)

0.001

  Stroke Buckleb

1628 (24)

347 (20)

  Neither Stroke Belt nor Stroke Buckle

2743 (40)

757 (43)

 Rural geography, N (%)

612 (10)

179 (11)

0.08

Medical conditionsc

 Hypertension, N (%)

4543 (67)

976 (56)

< 0.0001

 Dyslipidemia, N (%)

4246 (65)

994 (59)

< 0.0001

 Diabetes, N (%)

1580 (24)

264 (16)

< 0.0001

 Atrial fibrillation, N (%)

816 (12)

92 (5)

< 0.0001

 Myocardial infarction, N (%)

1168 (18)

234 (14)

< 0.0001

 Stroke, N (%)

576 (9)

106 (6)

< 0.001

Medications

 Number of medications, median (25th, 75th percentiles)

7 (4, 10)

4 (2, 7)

< 0.0001

 Anti-hypertensive medication, N (%)

4054 (61)

771 (44)

< 0.0001

 Insulin use, N (%)

412 (6)

50 (3)

0.04

 Statin use, N (%)

2841 (40)

527 (30)

< 0.001

Health behaviors

 Current smoker, N (%)

566 (8)

211 (12)

< 0.0001

 Alcohol use, moderate or heavy, N (%)

2242 (34)

617 (36)

0.02

 Exercise frequency, 0 times per week, N (%)

2467 (37)

564 (33)

< 0.001

Psychosocial variables

 Cares for a family member with a chronic illness or disability, N (%)

715 (11)

177 (10)

0.65

 Lack of social support, N (%)

274 (4)

81 (5)

0.24

 Depressive symptoms, N (%)

620 (9)

118 (7)

< 0.01

Physiological variables

 Body mass index, kg/m2, median (25th, 75th percentiles)

27.6 (24.6, 31.3)

27.3 (24.4, 30.5)

< 0.01

 Systolic blood pressure, mm Hg, median (25th, 75th percentiles)

129 (119, 139)

129 (120, 140)

0.26

 Total cholesterol, mg/dL, median (25th, 75th percentiles)

183 (159, 210)

190 (166, 220)

< 0.0001

 Low-density lipoprotein cholesterol, mg/dL, median (25th, 75th percentiles)

105 (85, 129)

114 (92, 137)

< 0.0001

 High-density lipoprotein cholesterol, mg/dL, median (25th, 75th percentiles)

49 (40, 61)

49 (39, 60)

0.68

 Glucose, mg/dL, median (25th, 75th percentiles)

95 (87, 109)

94 (88, 105)

0.04

 Estimated glomerular filtration rate, mL/min/1.73 m2, median (25th, 75th percentiles)

78.1 (63.6, 89.5)

83.0 (71.0, 90.7)

< 0.0001

 Urinary albumin-to-creatinine ratio, mg/g, median (25th, 75th percentiles)

9.1 (5.3, 20.2)

7.4 (4.8, 15.4)

< 0.0001

 C-reactive protein, mg/L, median (25th, 75th percentiles)

2.1 (0.9, 4.8)

1.8 (0.9, 4.2)

< 0.001

Self-rated health

 Self-rated general health, N (%)

   

  Excellent

966 (14)

421 (24)

< 0.0001

  Very good

2079 (31)

609 (35)

  Good

2495 (37)

511 (29)

  Fair

1022 (15)

165 (10)

  Poor

224 (3)

36 (2)

Ambulatory utilization

 Number of ambulatory visits, median (25th, 75th percentile)

10 (7, 15)

2 (0, 3)

< 0.0001

 Number of ambulatory providers, median (25th, 75th percentile)

4 (3, 6)

1 (0, 2)

< 0.0001

 Proportion of visits with the most frequently seen provider, median (25th, 75th percentile) d

0.44 (0.33, 0.58)

 Fragmentation score (reversed Bice-Boxerman Index), median (25th, 75th percentile) d

0.78 (0.65, 0.86)

  1. a Stroke Belt = North Carolina, South Carolina, Georgia, Tennessee, Mississippi, Alabama, Louisiana, and Arkansas (except for 153 coastal counties that constitute the Stroke Buckle) [17]
  2. b Stroke Buckle = 153 coastal counties in North Carolina, South Carolina, and Georgia [17, 18]
  3. c See Appendix 1 for detailed definitions of variables
  4. d Proportion of visits with the most frequently seen provider and fragmentation scores are not reliable if based on ≤3 visits [12]