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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
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BMC Public Health

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