| | | |
Crude HR
|
P-value
|
Model Ia
|
Model IIa
|
|---|
|
Variables
|
N
|
%
|
aHR
|
95% CI
|
aHR
|
95% CI
|
|---|
|
Children’s characteristics
|
|
Death
|
|
Yes
|
4258
|
19.34
|
4.71
|
< 0.001
|
4.47***
|
3.15–6.34
|
1.93**
|
1.27–2.95
|
|
No
|
17,753
|
80.66
|
1.00
| |
1.00
| |
1.00
| |
|
Diagnosis of catastrophic illness
|
|
One year or more
|
731
|
3.32
|
3.15
|
< 0.001
|
1.21
|
0.68–2.14
|
1.12
|
0.57–2.22
|
|
Less than one year
|
1646
|
7.48
|
2.83
|
< 0.001
|
0.98
|
0.64–1.52
|
1.13
|
0.68–1.87
|
|
No
|
19,634
|
89.20
|
1.00
| |
1.00
| |
1.00
| |
|
Family characteristics
|
|
Income levelb
|
|
High
|
6265
|
28.46
|
1.00
| |
1.00
| |
1.00
| |
|
Medium
|
10,637
|
48.33
|
1.22
|
0.302
|
1.21
|
0.83–1.76
|
1.23
|
0.81–1.86
|
|
Poverty
|
4597
|
20.89
|
1.86
|
0.003
|
1.42
|
0.94–2.15
|
1.52
|
0.95–2.43
|
|
Urbanizationb
|
|
Urban
|
5786
|
26.29
|
1.00
| |
1.00
| |
1.00
| |
|
Suburban
|
13,743
|
62.44
|
1.18
|
0.353
|
1.12
|
0.79–1.58
|
1.29
|
0.86–1.92
|
|
Rural
|
2112
|
9.60
|
1.02
|
0.939
|
0.97
|
0.55–1.72
|
1.09
|
0.58–2.05
|
|
Linkage with mother in health insurance
|
|
Yes
|
12,105
|
55.00
|
1.00
| |
1.00
| |
1.00
| |
|
No
|
9906
|
45.00
|
1.51
|
0.005
|
1.01
|
0.75–1.38
|
0.92
|
0.62–1.36
|
|
Paternal characteristics
|
|
Age at child’s death
|
|
< 35 years
|
7872
|
35.76
|
1.00
| | | |
1.00
| |
|
≥ 35 years
|
14,139
|
64.24
|
1.39
|
0.047
| | |
0.98
|
0.68–1.43
|
|
Premium payer (father)c
|
|
Yes
|
15,515
|
70.49
|
1.00
| | | |
1.00
| |
|
No
|
6129
|
27.85
|
0.90
|
0.524
| | |
0.69
|
0.44–1.07
|
|
Depressive disorders before child’s deathd
|
|
Yes
|
127
|
0.58
|
117.3
|
< 0.001
| | |
56.0***
|
34.5–90.8
|
|
No
|
21,884
|
99.42
|
1.00
| | | |
1.00
| |
|
Chronic physical conditione
|
|
Yes
|
3864
|
17.55
|
7.91
|
< 0.001
| | |
4.07***
|
2.90–5.73
|
|
No
|
18,147
|
82.45
|
1.00
| | | |
1.00
| |
- a Model I adjusted for children’s listed characteristics, gender, and age; Model II adjusted for children’s and paternal characteristics; ***P < 0.001; **P < 0.01; *P < 0.05
- b Within the year before the index child’s death
- c “No” refers to health insurance covered by the mother, children themselves, and grandparents
- d Depressive disorder (ICD-9-CM codes: 296.2X, 296.3X, 300.4X, and 311) is confirmed by receiving a diagnosis by a psychiatrist in (i) two or more outpatient services or (ii) one inpatient service within three years before the index child’s death
- e Chronic physical condition — including malignant neoplasms, chronic liver disease and cirrhosis, heart disease, cerebrovascular disease, diabetes, hypertensive disease, bronchitis, emphysema, asthma, and atherosclerosis — were obtained from the three-year reimbursement records prior to the index child’s death
