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Table 2 Patient, Hospital, and Community Factors Associated with an ACSC ED visit to High ACSC Hospitals

From: Emergency departments in the United States treating high proportions of patients with ambulatory care sensitive conditions: a retrospective cross-sectional analysis

 

High ACSC Hospital

aOR [95% CI]

High Chronic ACSC Hospital

aOR [95% CI]

High Acute ACSC Hospital

aOR [95% CI]

Patient Characteristics

Age

 65–74

Ref

Ref

Ref

 75–84

0.99 [0.98, 0.99]***

0.96 [0.95, 0.96]***

1.03 [1.02, 1.03]***

 85 + 

0.95 [0.94, 0.96] ***

0.89 [0.89, 0.90]***

1.06 [1.05, 1.07]***

Female

1.02 [1.02, 1.03]***

0.99 [0.99, 1.00]**

1.04 [1.03, 1.04]***

Race

 White

Ref

Ref

Ref

 Black

1.37 [1.36, 1.38]***

1.61 [1.60, 1.62]***

0.81 [0.80, 0.82]***

 Other

1.37 [1.36, 1.38]***

1.28 [1.27, 1.30]***

1.16 [1.15, 1.17]***

Elixhauser comorbidity index

 0–1

Ref

Ref

Ref

 2

1.17 [1.16, 1.17]***

1.22 [1.21, 1.24]***

1.04 [1.04, 1.05]***

 3 + 

1.26 [1.26, 1.27]***

1.39 [1.38, 1.40]***

1.04 [1.03, 1.05]***

Dual-eligible

1.18 [1.18, 1.19]***

1.20 [1.19, 1.20]***

1.11 [1.10, 1.11]***

Hospital Characteristics

 Teaching Hospital

  None

Ref

ref

Ref

  Minor teaching hospital

0.27 [0.26, 0.27]***

0.56 [0.56, 0.57]***

0.30 [0.30, 0.30]***

  Major teaching hospital

1.09 [1.08, 1.10]***

1.22 [1.21, 1.23]***

1.13 [1.13, 1.14]***

Community Characteristics

 Region

  Northeast

Ref

Ref

Ref

  Midwest

0.49 [0.49, 0.49]***

0.43 [0.43, 0.43]***

0.71 [0.70, 0.71]***

  South

0.38 [0.38, 0.39]***

0.35 [0.34, 0.35]***

0.54 [0.54, 0.55]***

  West

0.17 [0. 17, 0. 17]***

0.12 [0.12, 0.12]***

0.45 [0.45, 0.46]***

 Urbanicity

  Large central metro

Ref

Ref

Ref

  Large fringe metro

1.58 [1.57, 1.59]***

1.14 [1.13, 1.15]***

1.62 [1.61, 1.63]***

  Medium/small metro

0.41 [0.41, 0.41]***

0.35 [0.35, 0.36]***

0.77 [0.77, 0.78]***

  Micro/non-metropolitan

0.39 [0.38, 0.39]***

0.32 [0.32, 0.33]***

0.75 [0.74, 0.75]***

Hospital Community Characteristics

 % Poverty

1.003 [1.001, 1.004]***

1.08 [1.08, 1.08]***

1.00 [1.00, 1.00]

 Median household income

0.95 [0.95, 0.95]***

0.95 [0.95, 0.95]***

1.00 [1.00, 1.00]***

 Didn’t see doctor because of cost

1.00 [1.00, 1.00]***

1.02 [1.02, 1.02]***

0.99 [0.99, 0.99]***

 High housing costs

0.96 [0.96, 0.96]***

1.00 [1.00, 1.00]***

0.94 [0.93, 0.94]***

 High school education or higher

0.93 [0.93, 0.94]***

1.01 [1.00, 1.01]***

0.94 [0.94, 0.95]***

 Food insecurity

0.98 [0.97, 0.98]***

0.93 [0.93, 0.93]***

1.01 [1.01, 1.01]***

 Federally qualified health center/100 K

0.98 [0.98, 0.98]***

0.98 [0.98, 0.98]***

0.99 [0.99, 0.99]***

 Primary care / 100 K

1.00 [1.00, 1.00]***

1.00 [1.00, 1.00]***

1.00 [1.00, 1.00]***

Percent population by race

 % White

1.00 [1.00, 1.00]**

1.00 [1.00, 1.01] ***

1.00 [1.00, 1.00]***

 % Black

1.01 [1.01, 1.01]***

1.02 [1.01, 1.02]***

1.01 [1.01, 1.01]***

 % Hispanic

1.00 [1.00, 1.01]***

1.01 [1.00, 1.01]***

1.01 [1.01, 1.01]***

  1. ***p < 0.001, **p < 0.01, *p < 0.05
  2. Notes. “ED” emergency department, “ACSCs” ambulatory care sensitive conditions
  3. Results from logistic regression models with robust standard errors, where the outcome is whether the ACSC visit was to a hospital with a high proportion of ACSCs, a high proportion of chronic ACSCs, or a high proportion of acute ACSCs