Socioeconomic Inequality in One-Year Mortality of Elderly People with Hip Fracture in Taiwan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Study Cohort, Follow up, and Endpoint
2.3. Measures of Socioeconomic Status and Covariates
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Characteristics | No. of Patients a | One-Year Mortality | p-Value | |
---|---|---|---|---|
n (%) | Number | % | ||
Characteristics of residential city/township | ||||
Geographic area | ||||
North | 77,375 (40.1) | 7547 | 9.75 | <0.0001 |
Central | 51,095 (26.5) | 5743 | 11.24 | |
South | 56,247 (29.1) | 6038 | 10.73 | |
East | 7483 (3.9) | 906 | 12.11 | |
Urbanization status | ||||
Urban area | 65,254 (33.8) | 6469 | 9.91 | <0.0001 |
Satellite area | 51,482 (26.7) | 5268 | 10.23 | |
Rural area | 75,135 (38.9) | 8468 | 11.27 | |
City/township median family annual income b | ||||
Min.–Q1 | 42,374 (21.9) | 4974 | 11.74 | <0.0001 |
>Q1–Q3 | 87,410 (45.3) | 9319 | 10.66 | |
>Q3–Max. | 43,459 (22.5) | 4043 | 9.30 | |
Patient-level characteristics | ||||
Gender | ||||
Female | 118,370 (61.3) | 10,134 | 8.56 | <0.0001 |
Male | 74,748 (38.7) | 10,192 | 13.64 | |
Age, years | ||||
65–74 | 48,321 (25.0) | 3494 | 7.23 | <0.0001 |
75–84 | 93,310 (48.3) | 9241 | 9.90 | |
85+ | 51,527 (26.7) | 7593 | 14.74 | |
Comorbidity | ||||
Dementia | 7515 (3.9) | 999 | 13.29 | <0.0001 |
Stroke | 23,526 (12.2) | 2809 | 11.94 | <0.0001 |
COPD c | 16,223 (8.4) | 2966 | 18.28 | <0.0001 |
Heart failure | 13,060 (6.8) | 2773 | 21.23 | <0.0001 |
Hospital-level characteristics | ||||
Hospital accreditation level | ||||
Medical center | 54,405 (28.2) | 5305 | 9.75 | <0.0001 |
Regional hospital | 85,769 (44.4) | 8981 | 10.47 | |
Local hospital | 52,978 (27.4) | 6042 | 11.40 | |
Length of hospital stay d | ||||
Min–Q1 | 51,974 (26.9) | 5269 | 10.14 | <0.0001 |
Q1–Median | 45,679 (23.7) | 3385 | 7.41 | |
Median–Q3 | 50,959 (26.4) | 4306 | 8.45 | |
Q3–Max | 44,546 (23.1) | 7368 | 16.54 | |
Mean ± SD | 10.34 ± 16.44 | |||
Total | 193,158 (100.0) | 20,328 | 10.52 |
Characteristics | Odds Ratio | ||
---|---|---|---|
Crude Estimate (95% CI) | Adjusted Estimate (95% CI) | ||
Model 1 a | Model 2 b | ||
Characteristics of residential city/township | |||
Geographic area | |||
North | 0.78 (0.73–0.84) | 0.86 (0.79–0.94) | 0.87 *** (0.80–0.94) |
Central | 0.92 (0.85–0.99) | 0.96 (0.89–1.04) | 0.97 (0.90–1.05) |
South | 0.87 (0.81–0.94) | 0.98 (0.91–1.07) | 0.99 (0.91–1.07) |
East (Ref.) | 1.00 | 1.00 | 1.00 |
Urbanization status | |||
Urban area | 0.87 (0.84–0.90) | 1.04 (0.99–1.09) | 1.05 (1.00–1.10) |
Satellite area | 0.90 (0.87–0.93) | 0.98 (0.94–1.03) | 1.00 (0.96–1.05) |
Rural area (Ref.) | 1.00 | 1.00 | 1.00 |
City/Township median family annual income | |||
Min.–Q1 (Ref.) | 1.00 | 1.00 | 1.00 |
>Q1–Q3 | 0.90 (0.87–0.93) | 0.91 (0.87–0.94) | 0.91 *** (0.87–0.95) |
>Q3–Max. | 0.77 (0.74–0.81) | 0.80 (0.75–0.85) | 0.80 *** (0.75–0.85) |
Patient-level characteristics | |||
Gender | |||
Female (Ref.) | 1.00 | 1.00 | 1.00 |
Male | 1.69 (1.64–1.74) | 1.67 (1.62–1.72) | 1.67 *** (1.61–1.72) |
Age, years | |||
65–74 (Ref.) | 1.00 | 1.00 | 1.00 |
75–84 | 1.41 (1.35–1.47) | 1.36 (1.31–1.42) | 1.37 *** (1.31–1.43) |
≥85 | 2.22 (2.13–2.31) | 2.18 (2.08–2.28) | 2.18 *** (2.08–2.28) |
Comorbidity | |||
Dementia | 1.32 (1.23–1.41) | 1.15 (1.06–1.23) | 1.12 ** (1.04–1.20) |
Stroke | 1.18 (1.13–1.23) | 1.13 (1.08–1.18) | 1.10 *** (1.05–1.15) |
COPD | 2.06 (1.97–2.15) | 1.49 (1.42–1.57) | 1.41 *** (1.34–1.48) |
Heart failure | 2.50 (2.39–2.61) | 2.25 (2.15–2.37) | 2.11 *** (2.01–2.21) |
Hospital-level characteristics | |||
Hospital accreditation level | |||
Medical center | 1.00 | 1.00 | |
Regional hospital | 1.08 (1.04–1.12) | 1.05 ** (1.01–1.10) | |
Local hospital | 1.19 (1.15–1.24) | 1.14 *** (1.09–1.19) | |
Length of hospital stay c | |||
Min–Q1 | 1.00 | 1.00 | |
Q1–Median | 0.71 (0.68–0.74) | 0.71 *** (0.67–0.74) | |
Median–Q3 | 0.82 (0.78–0.85) | 0.79 *** (0.76–0.83) | |
Q3–Max | 1.76 (1.69–1.82) | 1.59 *** (1.53–1.66) |
Age Groups, Years | City/Township Median Family Annual Income | Adjusted Odds Ratios (95%CI) |
---|---|---|
65–74 | Min.–Q1 (Ref.) | 1.00 |
>Q1–Q3 | 0.89 (0.80–0.98) | |
>Q3–Max. | 0.84 (0.72–0.97) | |
75–84 | Min.–Q1 (Ref.) | 1.00 |
>Q1–Q3 | 0.92 (0.87–0.98) | |
>Q3–Max. | 0.79 (0.72–0.86) | |
≥85 | Min.–Q1 (Ref.) | 1.00 |
>Q1–Q3 | 0.91 (0.85–0.97) | |
>Q3–Max. | 0.80 (0.73–0.89) |
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Hsu, I.-L.; Chang, C.-M.; Yang, D.-C.; Chang, Y.-H.; Li, C.-C.; Hu, S.C.; Li, C.-Y. Socioeconomic Inequality in One-Year Mortality of Elderly People with Hip Fracture in Taiwan. Int. J. Environ. Res. Public Health 2018, 15, 352. https://doi.org/10.3390/ijerph15020352
Hsu I-L, Chang C-M, Yang D-C, Chang Y-H, Li C-C, Hu SC, Li C-Y. Socioeconomic Inequality in One-Year Mortality of Elderly People with Hip Fracture in Taiwan. International Journal of Environmental Research and Public Health. 2018; 15(2):352. https://doi.org/10.3390/ijerph15020352
Chicago/Turabian StyleHsu, I-Lin, Chia-Ming Chang, Deng-Chi Yang, Ya-Hui Chang, Chia-Chun Li, Susan C. Hu, and Chung-Yi Li. 2018. "Socioeconomic Inequality in One-Year Mortality of Elderly People with Hip Fracture in Taiwan" International Journal of Environmental Research and Public Health 15, no. 2: 352. https://doi.org/10.3390/ijerph15020352