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Table 3 Estimated risk difference for characteristics associated with resident transfers (N=12,787 resident-quarters)

From: Facility and resident characteristics associated with variation in nursing home transfers: evidence from the OPTIMISTIC demonstration project

 

All-cause Transfer (n=2,290)

Potentially Avoidable Hospitalization (n=487)

 

Marginal Effects

95% CI

Marginal Effects

95% CI

Individual-level Characteristics

 Aged ≤ 64 years

8.6

(5.0, 12.2)

1.5

(-0.2, 3.3)

 Aged 65-74 years

Reference

   

 Aged 75-84 years

-1.0

(-3.5, 1.5)

0.1

(-1.1, 1.3)

 Aged 85-94 years

-4.5

(-7.1, -2.0)

-1.4

(-2.5, -0.2)

 Aged ≥ 95 years

-7.7

(-10.9, -4.4)

-2.4

(-3.8, -1.1)

 Female

-2.6

(-4.4, -0.8)

-0.1

(-0.9, -0.7)

 White

Reference

   

 Black

3.4

(0.9, 6.0)

1.3

(0.1, 2.6)

 Other

-4.6

(-9.9, 0.8)

0.3

(-2.6, 3.3)

 Dual Eligible

-6.7

(-8.4, -5.1)

-2.5

(-3.3, -1.7)

 Cognitive Functioning Scale 1

Reference

   

 Cognitive Functioning Scale 2

-0.8

(-2.9, 1.3)

-0.3

(-1.4, 0.8)

 Cognitive Functioning Scale 3

-4.5

(-6.6, -2.5)

-1.2

(-2.2, -0.2)

 Cognitive Functioning Scale 4

-6.9

(-10.1, -3.8)

-3.3

(-4.4, -2.1)

 CHESS Score 0

Reference

   

 CHESS Score 1

1.9

(0.1, 3.6)

1.1

(0.3, 1.9)

 CHESS Score 2

4.7

(2.4, 7.0)

2.4

(1.2, 3.5)

 CHESS Score 3

9.3

(5.4, 13.1)

4.3

(2.0, 6.6)

 CHESS Score 4

13.8

(5.6, 22.0)

7.3

(1.5, 13.1)

 ADLs 1st Quartile (≤ 17)

Reference

   

 ADLs 2nd Quartile (18-19)

3.8

(1.9, 5.8)

0.8

(-0.2, 1.8)

 ADLs 3rd Quartile (20-21)

2.6

(0.6, 4.6)

-0.4

(-1.3, 0.6)

 ADLs 4th Quartile (22-28)

4.1

(1.1, 7.0)

-0.1

(-1.4, 1.3)

 Acute Myocardial Infarction

3.2

(0.6, 5.8)

1.3

(0.2, 2.4)

 Alzheimer’s Disease / Dementia

-3.0

(-5.2, -0.7)

0.4

(-0.1, 1.5)

 Chronic Kidney Disease

6.2

(4.3, 8.0)

1.6

(0.6, 2.5)

 Chronic Obstructive Pulmonary Disease

4.6

(2.8, 6.3)

1.0

(0.2, 1.9)

 Ischemic Heart Disease

2.2

(0.2, 4.1)

1.3

(0.3, 2.3)

 Hypertension

-6.9

(-10.1, -3.7)

-3.7

(-5.2, -2.1)

Facility-level Characteristics

 Payment Only Facility

Reference

   

 Payment + Clinical Model Facility

-4.1

(-6.2, -2.1)

-0.5

(-1.6, 0.4)

 Beds 1st Quartile (≤ 115 beds)

Reference

   

 Beds 2nd Quartile (116 – 147 beds)

-3.4

(-5.6, -1.1)

-0.9

(-1.9, 0.2)

 Beds 3rd Quartile (148 – 169 beds)

-0.2

(-2.7, 2.2)

0.7

(-0.5, 0.2)

 Beds 4th Quartile (≥ 170 beds)

-3.4

(-6.0, -0.1)

-0.9

(-2.1, 0.3)

 Overall Star Rating 1

13.0

(8.3, 17.6)

2.4

(-0.2, 4.9)

 Overall Star Rating 2

4.6

(1.7, 7.4)

0.6

(-0.9, 2.1)

 Overall Star Rating 3

1.7

(-0.5, 3.9)

-0.7

(-1.7, 0.3)

 Overall Star Rating 4

0.4

(-1.5, 2.3)

-0.2

(-1.2, 0.7)

 Overall Star Rating 5

Reference

   

 2017 Quarter 2

Reference

   

 2017 Quarter 3

1.3

(-0.7, 3.2)

1.2

(0.2, 2.1)

 2017 Quarter 4

2.5

(0.5, 4.5)

0.9

(-0.1, 1.9)

 2018 Quarter 1

3.2

(1.1, 5.2)

1.1

(0.1, 2.1)

 2018 Quarter 2

1.9

(-0.3, 4.0)

1.2

(0.1, 2.3)

  1. Model also controls for residents with congestive heart failure, diabetes, ischemic heart disease, depression, osteoporosis, stroke / transient ischemic attack and marital status, as well as facility characteristics staffing level, rural status, for-profit status, and multi-facility ownership
  2. Abbreviations: CI confidence interval, ADLs Activities of Daily Living, NHPPD nursing hours per patient day