The association between clinical integration of care and transfer of veterans with acute coronary syndromes from primary care VHA hospitals

Table 3 Results of conditional random effects logistic regression of transfer toVHA tertiary care compared to private tertiary care hospital

Variable	Odds ratio	p-value	Lower limit 95% CI	Upper limit 95% CI
Patient age 65 and over	1.42	0.29	0.75	2.71
Chronic obstructive pulmonary disease	0.56	0.15	0.25	1.23
Bleeding disorder	1.10	0.75	0.60	2.03
Smoker	1.14	0.84	0.34	3.77
Prior percutaneous coronary intervention	3.67	<0.001	1.91	7.04
Chronic heart failure	2.05	<0.001	1.43	2.95
ST segment elevation on presenting electrocardiogram	0.27	<0.001	0.14	0.51
Cardiac enzymes abnormal on presentation	0.30	0.02	0.11	0.81
Do not resuscitate during hospitalization	0.14	<0.001	0.04	0.54
In-hospital event*	1.47	0.31	0.70	3.08
Distance from patient home zip code centroid to hospital >100 miles	2.10	0.10	0.86	5.10
Distance from primary VHA to tertiary VHA hospital in miles	1.00	0.35	0.99	1.00
Degree of market competition (1 = not competitive; 3 = highly competitive)	0.19	0.06	0.03	1.05
VHA cardiologist on site	1.17	0.85	0.23	6.06
Tertiary VHA hospital has referral coordinator	20.62	<0.001	4.50	94.47
Primary VHA hospital has referral coordinator	1.38	0.69	0.27	6.99

* Presence of at least one of the following adverse events during admission: angina persisting more than 24 hours after admission; a hypotensive episode; an episode of heart failure; cardiac arrest; or positive stress test during admission

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