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Table 2 Predictors of group membership

From: Longitudinal patterns and predictors of healthcare utilization among cancer patients on home-based palliative care in Singapore: a group-based multi-trajectory analysis

Variable

Relative risk ratio (95% CI)

Base category for multinomial logit model = group 1

Univariable analysis

Multivariable analysis1

Group 2

Group 3

Group 2

Group 3

Age (per year decrease)

1.03 (1.02–1.04)

1.07 (1.05––1.08)

1.02 (1.01–1.04)

1.05 (1.04–1.06)

Gender (ref: male )

 Female

0.80 (0.60–1.06)

1.05 (0.78–1.43)

  

Ethnicity (ref: Chinese)

 Malay

1.02 (0.64–1.60)

0.87 (0.51–1.46)

  

 Indian

1.21 (0.64–2.29)

1.18 (0.60–2.33)

  

 Others

1.46 (0.69–3.06)

1.35 (0.62–2.96)

  

Religion (ref: Christianity)

 Buddhism

1.06 (0.72–1.56)

0.91 (0.60–1.38)

  

 Taoism

0.76 (0.42–1.38)

0.97 (0.54–1.73)

  

 Islam

1.02 (0.63–1.63)

0.73 (0.43–1.24)

  

 Others (including Hinduism)

1.32 (0.64–2.70)

1.21 (0.57–2.57)

  

 No religion

0.98 (0.51–1.88)

0.89 (0.42–1.87)

  

 Missing

Note2

  

Marital status (ref: married)

 Single

1.27 (0.69–2.34)

1.43 (0.75–2.70)

1.25 (0.57–2.73)

0.93 (0.42–2.05)

 Separated/divorced

0.95 (0.45–2.00)

1.58 (0.78–3.20)

0.78 (0.31–2.00)

1.05 (0.47–2.35)

 Widowed

0.54 (0.39–0.75)

0.35 (0.24–0.53)

0.90(0.57–1.43)

0.73 (0.45–1.19)

Residential status (ref: citizen)

 Permanent resident

1.26 (0.58–2.71)

1.6 (0.75–3.46)

  

At least one ACP component completed* (ref: yes)

 No

2.20 (1.64–2.96)

2.00 (1.46–2.75)

Note3

Preferred place of care (ref: home)

 Hospital

2.72 (1.53–4.83)

3.31 (1.82–6.02)

Note3

 Others (including No preference)

1.32 (0.72–2.42)

1.07 (0.53–2.17)

 ACP not done

2.67 (1.94–3.67)

2.54 (1.80–3.59)

 Missing

Note2

Preferred place of death (ref: home)

 Hospice

2.02 (1.04–3.91)

1.95 (0.93–4.07)

Note3

 Others (including No preference)

2.39 (1.46–3.91)

2.38 (1.42–3.99)

 ACP not done

2.98 (2.15–4.13)

2.62 (1.85–3.70)

 Missing

Note2

Preferred plan of care (ref: comfort only)

 Fully active/limited intervention

2.04 (1.35–3.07)

1.98 (1.26–3.10)

2.32 (1.45–3.69)

2.08 (1.31–3.30)

 ACP not done

3.05 (2.17–4.29)

2.87 (1.99–4.15)

3.35 (2.29–4.91)

2.74 (1.91–3.93)

 Missing

2.45 (1.21–4.94)

3.82 (1.90–7.70)

3.15 (1.44–6.91)

4.05 (1.93–8.50)

Patient awareness of diagnosis (ref: yes)

    

 No

0.74 (0.56–0.99)

0.44 (0.33–0.59)

1.2 (0.69–2.08)

0.75 (0.45–1.24)

 Missing

Note2

Note2

Patient awareness of prognosis (ref: yes)

 No

0.67 (0.50–0.89)

0.53 (0.39–0.72)

0.66 (0.38–1.14)

0.90 (0.56–1.43)

 Missing

Note2

Note2

Family awareness of diagnosis (ref: yes)

 No

3.21 (1.29–7.99)

4.21 (1.68–10.54)

2.23 (0.73–6.81)

2.02 (0.72–5.68)

 Missing

Note2

Note2

Family awareness of prognosis (ref: yes)

    

 No

1.10 (0.69–1.75)

1.76 (1.12–2.78)

0.79 (0.41–1.54)

1.03 (0.57–1.87)

 Missing

Note2

Note2

Housing value index (ref: low)

 Medium

1.16 (0.71–1.89)

1.46 (0.83–2.56)

  

 High

0.92 (0.53–1.60)

1.19 (0.63–2.23)

  

Medical subsidy means testing (ref: 51–80%)

 1–50%

0.93 (0.63–1.38)

1.31 (0.88–1.97)

0.65 (0.43–0.97)

0.88 (0.67–1.16)

 0%

1.17 (0.81–1.69)

1.73 (1.19–2.53)

1.18 (0.79–1.76)

1.57 (1.08–2.28)

 Not done

0.96 (0.41–2.26)

0.91 (0.36–2.32)

0.82 (0.30–2.24)

0.41 (0.14–1.19)

Main caregiver (ref: sSpouse)

 Relatives (children included in category)

0.72 (0.50–1.04)

0.48 (0.33–0.69)

Note3

 Others (including self)

1.45 (0.50–4.22)

1.51 (0.52–4.36)

 Missing

Note2

Primary decision maker (ref: spouse)

 Children/relatives

0.72 (0.50–1.05)

0.48 (0.33–0.70)

1.35 (0.94–1.94)

1.17 (0.96–1.44)

 Others (including self)

1.63 (0.50–5.29)

1.86 (0.58–5.97)

2.76 (0.69–11.05)

3.78 (1.04–13.73)

 Missing

Note2

Note2

Living arrangement (ref: with spouse only)

 With children only

0.51 (0.31–0.86)

0.45 (0.25–0.80)

0.63 (0.35–1.11)

0.74 (0.46–1.18)

 With spouse and children

1.07 (0.62–1.83)

1.31 (0.74–2.33)

0.96 (0.58–1.61)

0.87 (0.61–1.23)

 With relatives

0.92 (0.42–2.00)

0.80 (0.33–1.93)

0.58 (0.23–1.45)

0.46 (0.19–1.08)

 Others (including alone)

0.58 (0.35–0.96)

0.69 (0.40–1.19)

0.71 (0.42–1.19)

0.62 (0.42–0.92)

 Missing

Note2

Note2

Primary cancer diagnosis (ref: digestive organs)

 Lip, oral cavity, and pharynx

0.63 (0.29–1.41)

1.39 (0.61–3.17)

0.72 (0.29–1.75)

1.14 (0.47–2.77)

 Respiratory and intrathoracic organs

0.78 (0.53–1.15)

1.42 (0.92–2.19)

0.81 (0.53–1.23)

1.44 (0.94–2.21)

 Breast

0.63 (0.34–1.16)

2.08 (1.16–3.71)

0.35 (0.18–0.70)

1.36 (0.75–2.47)

 Female genital organs

0.66 (0.39–1.10)

1.86 (1.11–3.13)

0.64 (0.34–1.21)

1.49 (0.82–2.71)

 Male genital organs

0.92 (0.44–1.94)

1.58 (0.68–3.65)

0.68 (0.31–1.48)

1.47 (0.65–3.32)

 Urinary tract

0.36 (0.17–0.78)

1.17 (0.58–2.35)

0.39 (0.17–0.90)

1.37 (0.63–2.98)

 Lymphoid, haematopoietic, and related tissue

0.45 (0.15–1.34)

3.12 (1.4–6.95)

0.66 (0.2–2.18)

4.86 (2.20–10.74)

 Others

0.45 (0.25–0.80)

1.11 (0.62–1.98)

0.62 (0.32–1.19)

1.01 (0.54–1.89)

Charlson Comorbidity Index (per score increase)

1.20 (1.13–1.27)

1.03 (0.97–1.08)

1.16 (1.10–1.21)

1.03 (1.01–1.06)

ECOG performance status (ref: 3–4)

 0–2

1.34 (0.98–1.84)

3.27 (2.32–4.59)

0.94 (0.67–1.32)

2.33 (1.79–3.04)

 Not assessed

1.97 (1.19–3.27)

3.50 (2.04–5.98)

1.55 (0.89–2.73)

2.86 (1.77–4.64)

  1. Abbreviation: ACP advanced care planning, ECOG Eastern Cooperative Oncology Group
  2. 1Adjusted for both group membership and trajectory covariates. Group membership covariates included age at enrolment, marital status, preferred plan of care, awareness of diagnosis/prognosis by patient/family, medical subsidy means testing, primary decision maker, living arrangement, primary cancer diagnosis, Charlson Comorbidity Index, and ECOG performance status. Trajectory covariates included presence of unstable physical symptoms, presence of distressing psychosocial symptoms, and at least 4 HCA physical visitations per bi-week
  3. 2Estimates not shown due to extremely small cell count
  4. 3ACP done, preferred care place and preferred death place were collinear with preferred care plan, and main caregiver was collinear with the primary decision maker. These variables were dropped from the multivariable analysis
  5. *ACP components are (1) preferred place of care, (2) preferred place of death, and (3) preferred plan of care
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