Quarterly percent changes in RBC transfusions between 2015Q4 and 2018Q4 stratified by patient- and hospital-level characteristics
| Characteristics . | 2015Q4, % (95% CI) . | 2018Q4, % (95% CI) . | QPC, % (95% CI)* . | Ptrend† . |
|---|---|---|---|---|
| All subjects* | 4.22 (4.07-4.38) | 3.79 (3.63-3.96) | −0.72 (−1.26 to −0.19) | .008 |
| Sex | ||||
| Male | 4.33 (4.16-4.50) | 3.87 (3.70-4.05) | −0.70 (−1.26 to −0.15) | .013 |
| Female | 4.14 (3.99-4.29) | 3.73 (3.57-3.90) | −0.74 (−1.26 to −0.22) | .006 |
| Age, y | ||||
| <18 | 1.05 (0.91-1.21) | 1.00 (0.85-1.17) | −0.38 (−2.32 to 1.56) | .700 |
| 18-29 | 1.95 (1.84-2.07) | 1.82 (1.69-1.95) | −0.21 (−0.96 to 0.53) | .574 |
| 30-39 | 2.28 (2.16-2.41) | 2.30 (2.16-2.44) | 0.18 (−0.53 to 0.88) | .623 |
| 40-49 | 4.06 (3.86-4.27) | 3.81 (3.60-4.04) | −0.47 (−1.11 to 0.18) | .156 |
| 50-59 | 4.55 (4.36-4.76) | 4.09 (3.88-4.31) | −0.68 (−1.29 to −0.07) | .028 |
| 60-69 | 5.65 (5.41-5.89) | 4.88 (4.65-5.13) | −1.01 (−1.59 to −0.43) | .001 |
| 70-79 | 6.51 (6.26-6.77) | 5.61 (5.36-5.88) | −1.05 (−1.58 to −0.52) | <.001 |
| ≥80 | 7.00 (6.76-7.26) | 5.84 (5.60-6.09) | −1.32 (−1.81 to −0.84) | <.001 |
| Race‡ | ||||
| White | 4.12 (3.95-4.29) | 3.56 (3.39-3.73) | −0.88 (−1.45 to −0.31) | .003 |
| African American | 5.52 (5.24-5.81) | 5.09 (4.78-5.41) | −0.57 (−1.33 to 0.18) | .139 |
| Hispanic | 3.86 (3.64-4.10) | 3.55 (3.30-3.81) | −0.95 (−1.80 to −0.10) | .029 |
| Asian or Pacific Islander | 4.54 (4.16-4.96) | 4.61 (4.23-5.03) | 0.36 (−0.69 to 1.41) | .498 |
| Other | 4.14 (3.82-4.47) | 3.47 (3.16-3.81) | −1.40 (−2.56 to −0.24) | .019 |
| APR-DRG risk severity§ | ||||
| 1 | 1.04 (1.00-1.09) | 0.83 (0.79-0.88) | −2.11 (−2.65 to −1.58) | <.001 |
| 2 | 3.04 (2.93-3.15) | 2.44 (2.34-2.55) | −1.95 (−2.44 to −1.46) | <.001 |
| 3 | 7.08 (6.82-7.36) | 5.95 (5.69-6.23) | −1.39 (−1.92 to −0.87) | <.001 |
| 4 | 14.42 (13.77-15.10) | 10.70 (10.15-11.28) | −2.31 (−2.93 to −1.69) | <.001 |
| Primary payer | ||||
| Medicare | 6.31 (6.08-6.54) | 5.39 (5.16-5.63) | −1.09 (−1.61 to −0.57) | <.001 |
| Medicaid | 2.75 (2.62-2.88) | 2.69 (2.54-2.84) | −0.17 (−0.84 to 0.49) | .610 |
| Private | 2.91 (2.77-3.06) | 2.70 (2.55-2.85) | −0.51 (−1.19 to 0.17) | .140 |
| Self-pay | 3.12 (2.84-3.43) | 2.83 (2.59-3.09) | −0.33 (−1.43 to 0.76) | .553 |
| No chargeǁ | 3.72 (3.11-4.46) | 2.32 (1.72-3.12) | −4.44 (−6.95 to −1.93) | .001 |
| Admission type | ||||
| Nonelective | 4.53 (4.37-4.69) | 4.11 (3.93-4.29) | −0.64 (−1.16 to −0.12) | .016 |
| Elective | 3.18 (3.01-3.36) | 2.57 (2.41-2.73) | −1.55 (−2.28 to −0.83) | <.001 |
| Hospital control¶ | ||||
| Government, nonfederal | 4.33 (3.85-4.87) | 4.12 (3.62-4.68) | −0.41 (−2.02 to 1.20) | .618 |
| Private, nonprofit | 4.21 (4.02-4.40) | 3.88 (3.68-4.08) | −0.54 (−1.16 to 0.09) | .092 |
| Private, investor-owned | 4.21 (3.94-4.50) | 3.12 (2.81-3.46) | −2.08 (−3.29 to −0.88) | <.001 |
| Characteristics . | 2015Q4, % (95% CI) . | 2018Q4, % (95% CI) . | QPC, % (95% CI)* . | Ptrend† . |
|---|---|---|---|---|
| All subjects* | 4.22 (4.07-4.38) | 3.79 (3.63-3.96) | −0.72 (−1.26 to −0.19) | .008 |
| Sex | ||||
| Male | 4.33 (4.16-4.50) | 3.87 (3.70-4.05) | −0.70 (−1.26 to −0.15) | .013 |
| Female | 4.14 (3.99-4.29) | 3.73 (3.57-3.90) | −0.74 (−1.26 to −0.22) | .006 |
| Age, y | ||||
| <18 | 1.05 (0.91-1.21) | 1.00 (0.85-1.17) | −0.38 (−2.32 to 1.56) | .700 |
| 18-29 | 1.95 (1.84-2.07) | 1.82 (1.69-1.95) | −0.21 (−0.96 to 0.53) | .574 |
| 30-39 | 2.28 (2.16-2.41) | 2.30 (2.16-2.44) | 0.18 (−0.53 to 0.88) | .623 |
| 40-49 | 4.06 (3.86-4.27) | 3.81 (3.60-4.04) | −0.47 (−1.11 to 0.18) | .156 |
| 50-59 | 4.55 (4.36-4.76) | 4.09 (3.88-4.31) | −0.68 (−1.29 to −0.07) | .028 |
| 60-69 | 5.65 (5.41-5.89) | 4.88 (4.65-5.13) | −1.01 (−1.59 to −0.43) | .001 |
| 70-79 | 6.51 (6.26-6.77) | 5.61 (5.36-5.88) | −1.05 (−1.58 to −0.52) | <.001 |
| ≥80 | 7.00 (6.76-7.26) | 5.84 (5.60-6.09) | −1.32 (−1.81 to −0.84) | <.001 |
| Race‡ | ||||
| White | 4.12 (3.95-4.29) | 3.56 (3.39-3.73) | −0.88 (−1.45 to −0.31) | .003 |
| African American | 5.52 (5.24-5.81) | 5.09 (4.78-5.41) | −0.57 (−1.33 to 0.18) | .139 |
| Hispanic | 3.86 (3.64-4.10) | 3.55 (3.30-3.81) | −0.95 (−1.80 to −0.10) | .029 |
| Asian or Pacific Islander | 4.54 (4.16-4.96) | 4.61 (4.23-5.03) | 0.36 (−0.69 to 1.41) | .498 |
| Other | 4.14 (3.82-4.47) | 3.47 (3.16-3.81) | −1.40 (−2.56 to −0.24) | .019 |
| APR-DRG risk severity§ | ||||
| 1 | 1.04 (1.00-1.09) | 0.83 (0.79-0.88) | −2.11 (−2.65 to −1.58) | <.001 |
| 2 | 3.04 (2.93-3.15) | 2.44 (2.34-2.55) | −1.95 (−2.44 to −1.46) | <.001 |
| 3 | 7.08 (6.82-7.36) | 5.95 (5.69-6.23) | −1.39 (−1.92 to −0.87) | <.001 |
| 4 | 14.42 (13.77-15.10) | 10.70 (10.15-11.28) | −2.31 (−2.93 to −1.69) | <.001 |
| Primary payer | ||||
| Medicare | 6.31 (6.08-6.54) | 5.39 (5.16-5.63) | −1.09 (−1.61 to −0.57) | <.001 |
| Medicaid | 2.75 (2.62-2.88) | 2.69 (2.54-2.84) | −0.17 (−0.84 to 0.49) | .610 |
| Private | 2.91 (2.77-3.06) | 2.70 (2.55-2.85) | −0.51 (−1.19 to 0.17) | .140 |
| Self-pay | 3.12 (2.84-3.43) | 2.83 (2.59-3.09) | −0.33 (−1.43 to 0.76) | .553 |
| No chargeǁ | 3.72 (3.11-4.46) | 2.32 (1.72-3.12) | −4.44 (−6.95 to −1.93) | .001 |
| Admission type | ||||
| Nonelective | 4.53 (4.37-4.69) | 4.11 (3.93-4.29) | −0.64 (−1.16 to −0.12) | .016 |
| Elective | 3.18 (3.01-3.36) | 2.57 (2.41-2.73) | −1.55 (−2.28 to −0.83) | <.001 |
| Hospital control¶ | ||||
| Government, nonfederal | 4.33 (3.85-4.87) | 4.12 (3.62-4.68) | −0.41 (−2.02 to 1.20) | .618 |
| Private, nonprofit | 4.21 (4.02-4.40) | 3.88 (3.68-4.08) | −0.54 (−1.16 to 0.09) | .092 |
| Private, investor-owned | 4.21 (3.94-4.50) | 3.12 (2.81-3.46) | −2.08 (−3.29 to −0.88) | <.001 |
The data represent weighted estimates for approximately 40 million weighted discharges per year in the National Inpatient Sample (2015Q4-2018).
APR-DRG, All Patient Refined Diagnosis Related Group.
, where is the coefficient for the quarter variable in log binomial regression.
Ptrend was calculated using log binomial regression.
The race categories were predefined by Healthcare Cost and Utilization Project (HCUP) and includes race and ethnicity in 1 data element (RACE). If the source supplied race and ethnicity in separate data elements, ethnicity takes precedence over race in setting the HCUP value for race.
APR-DRG: Severity of illness subclass: (0) no class specified, (1) minor loss of function (includes cases with no comorbidity or complications), (2) moderate loss of function, (3) major loss of function, (4) extreme loss of function. APR-DRG classes 1 and 2 are considered low risk and classes 3 and 4 are considered high risk.
No payment/charity care/free care for indigent population.
The hospital's ownership/control category is obtained from the American Hospital Association Annual Survey of Hospitals and includes categories for government nonfederal (public), private not-for-profit (voluntary), and private investor-owned (proprietary). These types of hospitals tend to have different missions and different responses to government regulations and policies.