Factors associated with multiple transitions in care during the end of life following enrollment in a comprehensive palliative care program

Table 1 The association of patient characteristics to the total number of transitions

Characteristic	Rate Ratio (RR)
	Unadjusted (95% CI)	Adjusted* (95% CI)
Gender (vs male)
Female	0.86 (0.80, 0.94)	0.91 (0.84, 0.99)
Age (vs <65 years)
65–74	0.84 (0.76, 0.93)	0.86 (0.78, 0.95)
75–84	0.74 (0.67, 0.82)	0.82 (0.74, 0.90)
85+	0.69 (0.59, 0.81)	0.81 (0.69, 0.95)
Location of death (vs home)
Inpatient PCP unit	2.17 (1.95, 2.42)	2.18 (1.97, 2.42)
Hospital	1.23 (1.12, 1.35)	1.19 (1.09, 1.31)
Long term care	0.70 (0.55, 0.88)	0.78 (0.62, 0.97)
Year of death (vs 1998)
1999	0.81 (0.71, 0.93)	0.77 (0.68, 0.88)
2000	0.86 (0.76, 0.99)	0.77 (0.67, 0.87)
2001	0.75 (0.65, 0.86)	0.69 (0.60, 0.78)
2002	0.82 (0.71, 0.94)	0.73 (0.64, 0.83)
Diagnoses (vs other disease, no cancer)
Lung cancer	1.54 (1.28, 1.86)	1.29 (1.06, 1.58)
Colorectal	1.26 (1.02, 1.55)	1.08 (0.88, 1.33)
Female breast	1.09 (0.86, 1.35)	0.91 (0.73, 1.14)
Prostate	1.12 (0.88, 1.43)	1.00 (0.79, 1.27)
Lymphatic & hematopoietic tissue	1.49 (1.16, 1.90)	1.39 (1.09, 1.77)
All other cancers	1.43 (1.19, 1.72)	1.22 (1.01, 1.47)
Census residency indicator (vs urban)
Urban	0.95 (0.86, 1.03)	-
Neighbourhood income quintile (vs upper middle)
Low	1.07 (0.94, 1.22)	-
Lower middle	1.04 (0.91, 1.19)
Middle	1.01 (0.88, 1.14)
Upper	1.04 (0.91, 1.18)
Caregiver relationship (vs spouse/partner)
Child	0.85 (0.77, 0.94)	-
Parents/other relations	1.08 (0.96, 1.22)
Other	0.94 (0.74, 1.19)
Primary reason for referral to PCP (vs home consultation)
Pain	0.93 (0.84, 1.11)	-
Other symptom control	0.85 (0.73, 0.99)
Patient or family support	0.90 (0.78, 1.05)
Staff support	0.94 (0.71, 1.25)

* Controlled for all other variables in the model. The census residency indicator, neighbourhood income quintile, relationship of the primary caregiver and the primary reason for referral to the PCP were not significantly associated with the total number of transitions in the final multivariate regression model.
Notes: 1. The log number of days between date of PCP admission and death for each patient was accounted for in the regression as the 'offset'.
2. The regression coefficients were exponentiated to express effects as rate ratios.

ISSN: 1472-684X