Introduction
Methods
Data Source
Participants
Statistical Analysis
Results
White American (n = 1,188,771) | Native American (n = 11,886) | Black American (n = 333,424) | Hispanic American (n = 145,963) | Asian American (n = 12,390) | Other ethnicities (n = 36,811) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | N | % | N | % | N | % | |
Female | 714,362 | 60.1% | 7409 | 62.3% | 244,335 | 73.3% | 94,453 | 64.7% | 7110 | 57.4% | 23,532 | 63.9% |
Age, mean (SD) | 59.4 | 12.9 | 53.5 | 13.7 | 53.7 | 13.8 | 54.4 | 14.8 | 54.8 | 14.7 | 56.0 | 14.2 |
Insurance | ||||||||||||
Medicare | 608,198 | 51.2% | 4769 | 40.1% | 143,579 | 43.1% | 56,995 | 39.1% | 4567 | 36.9% | 14,816 | 40.3% |
Medicaid | 132,511 | 11.2% | 2610 | 22.0% | 76,305 | 22.9% | 35,137 | 24.1% | 2721 | 22.0% | 7118 | 19.3% |
Private insurance | 372,138 | 31.3% | 2985 | 25.1% | 85,757 | 25.7% | 39,321 | 26.9% | 4274 | 34.5% | 11,744 | 31.9% |
Others | 75,924 | 6.4% | 1522 | 12.8% | 27,783 | 8.3% | 14,510 | 9.9% | 828 | 6.7% | 3133 | 8.5% |
Location | ||||||||||||
Central counties | 240,633 | 20.2% | 2174 | 18.3% | 148,973 | 44.7% | 73,549 | 50.4% | 4957 | 40.0% | 16,722 | 45.4% |
Large metro | 303,368 | 25.5% | 1362 | 11.5% | 74,555 | 22.4% | 21,997 | 15.1% | 2146 | 17.3% | 8315 | 22.6% |
Medium metro | 248,259 | 20.9% | 2409 | 20.3% | 53,431 | 16.0% | 31,522 | 21.6% | 3474 | 28.0% | 4903 | 13.3% |
Small metro | 136,467 | 11.5% | 1385 | 11.7% | 24,920 | 7.5% | 8802 | 6.0% | 581 | 4.7% | 2292 | 6.2% |
Micropolitan | 157,299 | 13.2% | 2556 | 21.5% | 19,169 | 5.8% | 7094 | 4.9% | 1043 | 8.4% | 2630 | 7.1% |
Not metropolitan or Micropolitan | 102,745 | 8.6% | 2000 | 16.8% | 12,376 | 3.7% | 2999 | 2.1% | 189 | 1.5% | 1949 | 5.3% |
Income | ||||||||||||
First quartile | 330,690 | 27.8% | 5978 | 50.3% | 174,364 | 52.3% | 60,923 | 41.7% | 2078 | 16.8% | 12,102 | 32.9% |
Second quartile | 347,352 | 29.2% | 3058 | 25.7% | 73,591 | 22.1% | 35,286 | 24.2% | 2487 | 20.1% | 8869 | 24.1% |
Third quartile | 299,304 | 25.2% | 2007 | 16.9% | 53,321 | 16.0% | 32,657 | 22.4% | 3826 | 30.9% | 9159 | 24.9% |
Fourth quartile | 211,425 | 17.8% | 843 | 7.1% | 32,148 | 9.6% | 17,097 | 11.7% | 3999 | 32.3% | 6681 | 18.2% |
Type II Diabetes | 768,780 | 64.7% | 8638 | 72.7% | 212,438 | 63.7% | 102,038 | 69.9% | 8798 | 71.0% | 23,931 | 65.0% |
Hypertension | 843,061 | 70.9% | 7846 | 66.0% | 233,224 | 70.0% | 97,971 | 67.1% | 7745 | 62.5% | 26,467 | 71.9% |
Hospital characteristics | ||||||||||||
Private hospital | 1,074,291 | 90.4% | 10,504 | 88.4% | 293,190 | 87.9% | 129,109 | 88.5% | 11,071 | 89.4% | 33,132 | 90.0% |
Hospital in urban area | 1043,329 | 87.8% | 9265 | 78.0% | 314,278 | 94.3% | 141,167 | 96.7% | 11,545 | 93.2% | 34,456 | 93.6% |
Teaching hospital | 571,814 | 48.1% | 5549 | 46.7% | 212,388 | 63.7% | 79,586 | 54.5% | 6830 | 55.1% | 20,005 | 54.4% |
Hospital bed size | ||||||||||||
Small | 188,445 | 15.9% | 2018 | 17.0% | 45,458 | 13.6% | 21,822 | 15.0% | 2221 | 17.9% | 5756 | 15.6% |
Medium | 328,200 | 27.6% | 3078 | 25.9% | 94,294 | 28.3% | 40,610 | 27.8% | 3361 | 27.1% | 9714 | 26.4% |
Large | 672,126 | 56.5% | 6790 | 57.1% | 193,672 | 58.1% | 83,531 | 57.2% | 6808 | 55.0% | 21,341 | 58.0% |
ACCI, median (IQR) | 3 | (2–6) | 3 | (2–5) | 3 | (1–5) | 3 | (1–5) | 3 | (2–6) | 3 | (1–5) |
Number of procedures, median (IQR) | 1 | (0–3) | 1 | (0–3) | 1 | (0–2) | 1 | (0–2) | 1 | (0–3) | 1 | (0–3) |
Model 1 | Model 2 | Model 3 | Model 4 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | |||||
Lower | Upper | Lower | Upper | Lower | Upper | Lower | Upper | |||||
White Americans | Ref | Ref | Ref | Ref | ||||||||
Native Americans | 0.671*** | 0.618 | 0.728 | 0.648*** | 0.595 | 0.707 | 0.585*** | 0.537 | 0.637 | 0.722*** | 0.661 | 0.79 |
Black Americans | 0.818*** | 0.805 | 0.831 | 0.690*** | 0.677 | 0.702 | 0.601*** | 0.59 | 0.611 | 0.711*** | 0.699 | 0.725 |
Asian Americans | 1.154*** | 1.081 | 1.231 | 0.720*** | 0.67 | 0.773 | 0.963 | 0.899 | 1.031 | 0.838*** | 0.779 | 0.902 |
Hispanic Americans | 1.199*** | 1.175 | 1.223 | 1.061*** | 1.038 | 1.085 | 0.871*** | 0.853 | 0.889 | 1.077*** | 1.053 | 1.102 |
Other races/ethnicities | 1.597*** | 1.545 | 1.651 | 1.357*** | 1.307 | 1.409 | 1.280*** | 1.235 | 1.327 | 1.365*** | 1.314 | 1.418 |
Discharge to healthcare facility OR (95% CI) | Length of stay Days (95% CI) | Hospital costs 2016 USD (95% CI) | ||||
---|---|---|---|---|---|---|
Unadjusted models | Adjusted models Φ | Unadjusted models | Adjusted models Φ | Unadjusted models | Adjusted models Φ | |
White Americans | Ref | Ref | Ref | Ref | Ref | Ref |
Native Americans | 0.23* (0.1–0.56) | 0.26* (0.11–0.64) | − 0.28* (− 0.36 to − 0.2) | − 0.33* (− 0.41 to − 0.25) | − 595* (− 1050 to − 139) | − 775*** (− 1204 to − 346) |
Black Americans | 1.49* (1.38–1.61) | 1.2* (1.1–1.3) | 0.12* (0.1 to 0.15) | 0.09* (0.06 to 0.12) | − 33 (− 143 to 77) | 378* (277 to 479) |
Asian Americans | 0.32* (0.18–0.58) | 0.5* (0.28–0.9) | − 0.02 (− 0.33 to 0.29) | 0.12 (− 0.23 to 0.48) | 1873* (995 to 2750) | 674 (− 65 to 1412) |
Hispanic Americans | 0.87* (0.78–0.98) | 0.74* (0.65–0.83) | − 0.06* (− 0.09 to − 0.03) | − 0.05* (− 0.08 to − 0.02) | − 441* (− 571 to − 311) | − 41 (− 162 to 80) |
Other ethnicities | 0.86 (0.72–1.04) | 0.79* (0.65–0.96) | 0.02 (− 0.03 to 0.06) | − 0.02 (− 0.07 to 0.03) | − 174 (− 430 to 82) | − 11 (− 220 to 197) |