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Table 4 Characteristics and adjusted odds ratio of discharge against medical advice (DAMA), routine, and transfer discharges among inpatient drug-detoxification hospitalizations for patients aged≥12 years: 2003–2011 Nationwide Inpatient Samples

From: National trends and characteristics of inpatient detoxification for drug use disorders in the United States

Detoxification discharge status DAMA Routine Transfer to further treatment DAMA (1) vs. routine (0) DAMA (1) vs. transfer to further treatment (0)
Sample size, unweighted N (weighted row %) 36,885 (13.67%) 208,291 (76.65%) 25,566 (9.44%) 219,536b 54,832b
Weighted column %/Adjusted odds ratio (AOR) % (95% CI) % (95% CI) % (95% CI) AOR (95% CI) p value AOR (95% CI) p value
Age group, years
 12–17 0.25 (0.16–0.40) 0.79 (0.47–1.34) 0.91 (0.59–1.42) 0.39 (0.26–0.57) < 0.001 0.34 (0.19–0.61) < 0.001
 18–25 16.16 (14.42–18.07) 13.56 (12.41–14.79) 13.82 (12.51–15.24) 1.00   1.00  
 26–34 27.20 (25.96–28.48) 21.94 (20.86–23.05) 20.51 (19.45–21.62) 0.98 (0.93–1.03) 0.469 1.06 (0.98–1.16) 0.157
 35–49 44.65 (42.43–46.88) 45.30 (43.68–46.94) 43.39 (41.34–45.46) 0.72 (0.67–0.78) < 0.001 0.85 (0.76–0.94) 0.003
 50–64 11.17 (10.10–12.34) 16.89 (15.77–18.08) 18.17 (16.99–19.42) 0.53 (0.48–0.58) < 0.001 0.56 (0.49–0.63) < 0.001
 65+ 0.57 (0.45–0.71) 1.51 (1.32–1.73) 3.19 (2.64–3.84) 0.33 (0.27–0.40) < 0.001 0.18 (0.14–0.24) < 0.001
Sex
 Male 70.99 (69.35–72.57) 64.30 (62.99–65.58) 64.91 (63.01–66.76)     
 Female 28.87 (27.29–30.49) 35.58 (34.31–36.87) 35.00 (33.16–36.89) 0.88 (0.85–0.91) < 0.001 0.85 (0.80–0.91) < 0.001
Race/Ethnicity
 White, non-Hispanic 43.23 (38.42–48.18) 44.48 (40.77–48.24) 48.73 (44.72–52.77) 1.00   1.00  
 Black, non-Hispanic 19.98 (16.75–23.66) 20.94 (17.70–24.61) 20.54 (17.31–24.20) 0.84 (0.74–0.96) 0.011 1.03 (0.85–1.25) 0.762
 Hispanic 13.15 (9.70–17.60) 8.97 (7.18–11.17) 9.95 (7.86–12.53) 0.98 (0.86–1.12) 0.758 1.11 (0.83–1.47) 0.481
 Asian/Pacific-Islander/Native-American 0.63 (0.46–0.86) 0.68 (0.52–0.90) 0.65 (0.50–0.85) 1.02 (0.79–1.32) 0.851 1.37 (1.01–1.85) 0.044
 Other races, non-Hispanic 5.52 (3.68–8.20) 3.54 (2.56–4.87) 3.95 (2.87–5.40) 1.07 (0.88–1.31) 0.490 1.25 (0.95–1.66) 0.112
 Unknowna 14.21 (10.74-18.57) 17.81 (14.20–22.10) 12.39 (9.66–15.76) 1.07 (0.88–1.31) 0.485 1.24 (0.90–1.69) 0.183
Household income
 Lowest quartile 37.70 (33.71–41.87) 36.93 (34.05–39.92) 30.66 (27.26–34.28) 1.00   1.00  
 2nd quartile 19.81 (17.95–21.82) 20.90 (19.65–22.21) 21.03 (18.68–23.59) 1.00 (0.93–1.07) 0.938 0.79 (0.65–0.95) 0.012
 3rd quartile 17.03 (15.28–18.93) 18.65 (17.32–20.06) 21.62 (18.24–25.43) 0.93 (0.86–1.00) 0.055 0.66 (0.51–0.86) 0.002
 Highest quartile 16.94 (14.34–19.91) 17.68 (15.99–19.50) 18.14 (15.99–20.50) 0.90 (0.81–1.00) 0.060 0.78 (0.66–0.93) 0.006
Primary expected payer
 Medicare 9.08 (8.21–10.04) 11.98 (11.20–12.80) 15.13 (13.36–17.09) 1.62 (1.50–1.75) < 0.001 1.38 (1.20–1.59) < 0.001
 Medicaid 47.27 (42.00–52.60) 38.61 (34.70–42.67) 39.92 (35.29–44.74) 1.64 (1.49–1.81) < 0.001 1.60 (1.33–1.91) < 0.001
 Private 14.85 (12.75–17.24) 23.89 (21.46–26.50) 24.35 (21.30–27.68) 1.00   1.00  
 Self-pay 22.08 (18.33–26.35) 18.67 (15.78–21.96) 12.34 (10.76–14.13) 1.68 (1.49–1.89) < 0.001 2.43 (1.94–3.06) < 0.001
 Other payers 6.57 (4.74–9.04) 6.62 (5.41–8.07) 8.07 (5.81–11.12) 1.70 (1.35–2.13) < 0.001 0.99 (0.74–1.33) 0.954
Hospital region
 Northeast 58.49 (51.60–65.06) 40.51 (35.16–46.09) 51.11 (44.61–57.58) 1.00   1.00  
 Midwest 16.41 (12.45–21.31) 22.04 (17.65–27.17) 13.67 (10.98–16.88) 0.60 (0.50–0.72) < 0.001 1.30 (0.89–1.90) 0.180
 South 17.01 (12.68–22.43) 27.08 (22.91–31.69) 20.37 (16.55–24.79) 0.53 (0.44–0.63) < 0.001 1.01 (0.72–1.41) 0.967
 West 8.10 (6.25–10.44) 10.37 (8.47–12.64) 14.86 (11.11–19.59) 0.77 (0.65–0.92) 0.004 0.78 (0.57–1.06) 0.115
Hospital location
 Rural 5.87 (3.93–8.67) 7.01 (5.36–9.14) 8.57 (6.20–11.72) 1.00   1.00  
 Urban 94.10 (91.30–96.04) 92.84 (90.71–94.50) 91.34 (88.19–93.71) 1.04 (0.81–1.33) 0.768 1.75 (1.28–2.40) < 0.001
Any-listed alcohol use disorder
 No 55.93 (51.94–59.85) 59.05 (55.91–62.12) 48.59 (45.67–51.51) 1.00   1.00  
 Yes 44.07 (40.15–48.06) 40.95 (37.88–44.09) 51.41 (48.49–54.33) 1.13 (1.06–1.21) < 0.001 0.83 (0.75–0.92) < 0.001
Any-listed opioid use disorder
 No 18.92 (16.60–21.47) 25.36 (23.21–27.63) 32.61 (29.82–35.53) 1.00   1.00  
 Yes 81.08 (78.53–83.40) 74.64 (72.37–76.79) 67.39 (64.47–70.18) 1.33 (1.23–1.45) < 0.001 1.73 (1.49–2.02) < 0.001
Any-listed any non-addiction mental health disorderc
 No 67.58 (65.03–70.03) 50.19 (47.39–52.99) 45.03 (41.95–48.14) 1.00   1.00  
 Yes 32.42 (29.97–34.97) 49.81 (47.01–52.61) 54.97 (51.86–58.05) 0.58 (0.54–0.62) < 0.001 0.46 (0.42–0.51) < 0.001
  1. DAMA discharges against medical advice, AOR adjusted odds ratio, CI confidence interval
  2. We reduced the significant level to 0.01 due to a relatively large sample. Boldface: p < 0.01
  3. aRace/ethnicity information were not available in some states in some years, which were coded into unknown category
  4. bHospitalizations with missing values or zero trend weight were excluded. The regression model included all variables listed in the first column and controlled for survey year
  5. cAny mental health disorder included adjustment disorders, anxiety disorders, attention-deficit, conduct, and disruptive behavior disorders, impulse control disorders, mood disorders, personality disorders, schizophrenia, psychotic, delusional disorders