Exploration of Asthma & Allergy

Table 4. Odds ratios for non-routine disposition after asthma-related ED visit (regression using 10× imputed dataset, n = 44,196,290)

Variable	AOR	95% CI	p-value
Context
Year of visit
2005 (ref.)
2006	1.00	(0.98, 1.02)	0.9225
2007	1.04	(1.03, 1.06)	< 0.0001
2008	0.85	(0.84, 0.87)	< 0.0001
2009	0.90	(0.88, 0.91)	< 0.0001
2010	1.00	(0.98, 1.01)	0.539
2011	1.01	(1.00, 1.03)	0.1272
2012	1.01	(1.00, 1.03)	0.096
2013	1.05	(1.03, 1.06)	< 0.0001
2014	1.10	(1.09, 1.12)	< 0.0001
Patient three-digit zip code
Los Angeles (ref.)
Homeless/unknown	1.80	(1.73, 1.88)	< 0.0001
Bakersfield vicinity	1.29	(1.17, 1.41)	< 0.0001
Ventura	1.23	(1.10, 1.38)	0.0002
Santa Barbara	1.22	(0.98, 1.52)	0.0807
Mojave	1.19	(1.09, 1.31)	0.0002
Pasadena	1.16	(1.05, 1.28)	0.004
Glendale	1.15	(1.04, 1.26)	0.0045
Burbank	1.13	(0.99, 1.29)	0.0602
Santa Monica	1.12	(0.98, 1.29)	0.0996
San Francisco	1.11	(1.03, 1.21)	0.0097
Torrance	1.07	(0.97, 1.18)	0.1782
San Luis Obispo	1.07	(0.89, 1.28)	0.458
Alhambra	1.06	(0.92, 1.22)	0.3961
San Bernardino	1.06	(0.98, 1.14)	0.1374
San Rafael	1.06	(0.94, 1.18)	0.3311
Santa Ana vicinity	1.05	(0.98, 1.13)	0.1456
San Mateo	1.05	(0.94, 1.17)	0.4201
Sacramento vicinity 1	1.05	(0.98, 1.11)	0.1515
San Bernardino vicinity	1.04	(0.98, 1.10)	0.1969
Eureka	1.03	(0.84, 1.27)	0.7503
Long Beach vicinity	1.03	(0.97, 1.09)	0.2878
Santa Rosa	1.03	(0.92, 1.14)	0.6431
Fresno	1.01	(0.91, 1.12)	0.8441
Long Beach	1.01	(0.94, 1.07)	0.8557
Inglewood vicinity	1.00	(0.96, 1.05)	0.8904
Inglewood	1.00	(0.92, 1.07)	0.9305
Anaheim	0.99	(0.94, 1.05)	0.7281
San Diego North	0.99	(0.92, 1.06)	0.7574
Van Nuys vicinity	0.98	(0.92, 1.05)	0.6024
Redding	0.98	(0.84, 1.16)	0.8328
San Diego South	0.98	(0.91, 1.06)	0.6116
Richmond	0.98	(0.90, 1.06)	0.5837
Pasadena vicinity	0.98	(0.89, 1.07)	0.5829
Indio	0.98	(0.89, 1.07)	0.6124
Sacramento	0.97	(0.90, 1.03)	0.3128
San Diego	0.96	(0.90, 1.04)	0.3123
San Francisco South	0.96	(0.89, 1.03)	0.2601
Whittier	0.96	(0.91, 1.01)	0.1053
Hollywood	0.96	(0.87, 1.05)	0.353
Riverside	0.95	(0.90, 1.02)	0.1512
Fresno vicinity	0.94	(0.86, 1.03)	0.2095
Santa Ana	0.93	(0.86, 1.01)	0.0793
San Jose vicinity	0.93	(0.86, 1.01)	0.1001
Reno (NV)	0.92	(0.75, 1.12)	0.3821
Alhambra vicinity	0.92	(0.87, 0.96)	0.0005
San Jose	0.91	(0.84, 0.98)	0.0182
Van Nuys	0.91	(0.83, 0.99)	0.0235
Stockton North	0.89	(0.82, 0.97)	0.0103
Sacramento east/vicinity 2	0.89	(0.82, 0.97)	0.01
Stockton South	0.89	(0.82, 0.96)	0.0028
Bakersfield	0.88	(0.79, 0.98)	0.0214
Palo Alto	0.87	(0.78, 0.98)	0.0166
Oakland	0.86	(0.81, 0.92)	< 0.0001
Oakland vicinity	0.86	(0.82, 0.91)	< 0.0001
Marysville	0.85	(0.76, 0.96)	0.0078
Outside of California	0.84	(0.80, 0.89)	< 0.0001
Salinas	0.84	(0.68, 1.03)	0.1011
Berkeley	0.75	(0.67, 0.83)	< 0.0001
Hospital control
Government	1.38	(1.30, 1.47)	< 0.0001
For-Profit	0.86	(0.82, 0.90)	< 0.0001
Non-Profit (ref.)
Hospital teaching/location
Urban, non-teaching (ref.)
Rural, non-teaching	1.22	(1.14, 1.32)	< 0.0001
Urban, teaching	0.80	(0.76, 0.84)	< 0.0001
Hospital licensed bed size
0 to 49 beds	1.79	(1.52, 2.10)	< 0.0001
50 to 99 beds	0.94	(0.89, 0.99)	0.0262
100 to 149 beds	0.75	(0.72, 0.79)	< 0.0001
150 to 199 beds	0.91	(0.87, 0.96)	0.0001
200 to 299 beds	0.86	(0.82, 0.91)	< 0.0001
300 to 499 beds	1.15	(1.07, 1.23)	< 0.0001
500+ beds (ref.)
Hospital system status
In system of 3+ hospitals	0.99	(0.97, 1.01)	0.2128
Not in a system (ref.)
DSH status
DSH hospital	1.00	(0.99, 1.02)	0.7694
Non-DSH hospital (ref.)
Hospital Kaiser Permanente status
Non-Kaiser (ref.)
Kaiser	0.59	(0.53, 0.65)	< 0.0001
Pre-disposing
Sex
Male	1.06	(1.05, 1.06)	< 0.0001
Female (ref.)
Age group
0 to 17 years	0.98	(0.95, 1.00)	0.0716
18 to 64 years (ref.)
65 years and greater	1.23	(1.21, 1.26)	< 0.0001
Race
Non-White	1.00	(0.99, 1.01)	0.9535
White (ref.)
Ethnicity
Hispanic	0.96	(0.95, 0.97)	< 0.0001
Non-Hispanic (ref.)
Predisposing-vulnerable domain (any versus no diagnosis)
Anxiety disorders	1.04	(1.03, 1.05)	< 0.0001
Attention-deficit, conduct, and disruptive behavior disorders	1.16	(1.13, 1.19)	< 0.0001
Mood disorders	1.35	(1.34, 1.36)	< 0.0001
Schizophrenia and other psychotic disorders	1.97	(1.94, 1.99)	< 0.0001
Suicide and intentional self-inflicted injury	4.74	(4.67, 4.81)	< 0.0001
Enabling
Payer source
Self-pay	0.87	(0.86, 0.88)	< 0.0001
Medicare	1.15	(1.13, 1.17)	< 0.0001
Medicaid	0.77	(0.76, 0.78)	< 0.0001
Private insurance (ref.)
Other government	0.80	(0.78, 0.83)	< 0.0001
Other	1.68	(1.64, 1.71)	< 0.0001
Need
Asthma
Secondary diagnosis (ref.)
Primary diagnosis	0.87	(0.86, 0.87)	< 0.0001

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Model also includes dummy variables to represent 349 unique hospitals. AOR: adjusted odds ratio; DSH: Disproportionate Share Hospital; CI: confidence interval

Declarations

Author contributions

JEB: Conceptualization, Formal analysis, Writing—original draft. ICE: Writing—review & editing. CG: Writing—review & editing. MW: Writing—review & editing. JMB: Writing—review & editing.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Ethical approval for this study was obtained by the Loma Linda University Health Institutional Review Board which determined that this was not human subjects research (IRB# 5240531).

Consent to participate

The informed consent to participate in this study was exempted by Loma Linda University Health Institutional Review Board due to analyzing public-use data.

Consent to publication

Not applicable.

Availability of data and materials

Public-use data is no longer available. Confidential emergency department data for California may be obtained at: https://hcai.ca.gov/data-and-reports/research-data-request-information/#patient-discharge-data-pdd

Funding

Not applicable.

Copyright

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