Table 3

Association between patient characteristics and probability of receiving low-value care (narrower definition) for adults aged ≥18 in the fiscal year (FY) 2019

Adjusted OR
(95% CI)
At least one of the 33 low-value servicesAntibiotics prescription for the common coldSerum T3 level testing for hypothyroidismSpinal injection for low back painSpinal fusion for lumbar stenosis
Patients’ age
(every 10 years)
0.90***
(0.90 to 0.91)
0.75***
(0.74 to 0.76)
1.03**
(1.01 to 1.06)
1.30***
(1.26 to 1.34)
1.43***
(1.28 to 1.61)
Patients’ sex
(reference: male)
Female1.37***
(1.32 to 1.41)
1.02
(0.96 to 1.08)
1.74***
(1.60 to 1.88)
1.06
(0.95 to 1.19)
1.04
(0.62 to 1.73)
Charlson’s comorbidity score
(reference: 0–1)
2–41.51***
(1.45 to 1.57)
1.49***
(1.38 to 1.60)
2.73***
(2.50 to 2.98)
0.68***
(0.59 to 0.79)
0.54
(0.27 to 1.08)
5+2.45***
(2.29 to 2.63)
2.61***
(2.31 to 2.96)
6.04***
(5.35 to 6.82)
0.96
(0.74 to 1.26)
0.59
(0.14 to 2.42)
Size of treating hospital
(reference: small)
Medium0.82***
(0.78 to 0.86)
0.60***
(0.55 to 0.64)
1.16
(0.99 to 1.35)
0.45***
(0.39 to 0.51)
1.10
(0.43 to 2.84)
Large0.73***
(0.69 to 0.77)
0.37***
(0.34 to 0.41)
1.53***
(1.31 to 1.78)
0.31***
(0.26 to 0.37)
1.53
(0.58 to 4.01)
  • The size of the treating hospital was categorised according to the number of beds as follows: small (<200 beds), medium (200–499 beds) and large (≥500 beds). After excluding 10 945 patients (3.6%) who had missing data on comorbidities, we analysed 292 275 adult patients seeking care at an analytic acute care hospital, including outpatient and/or inpatient services, at least once in FY2019 (note that the same individual might be double-counted if he or she visited a different hospital). We regressed the indicator of receiving at least one of the 33 low-value services in FY2019 on the patient characteristics (age, sex and Charlson’s comorbidity score at the first visit of FY2019) and treating hospital size by using logistic regression with Huber-White robust standard errors. We similarly calculated the OR for receiving each of the four selected low-value services at least once in the year in the same manner. Antibiotics prescription for common cold and T3 level testing for hypothyroidism are the two services with most episodes involving low-value care (narrower definition), and spinal injection for low back pain and spinal fusion for lumbar stenosis are the two services accounting for the greatest healthcare spending in FY2019.

  • **P<0.01, ***p<0.001.

  • T3, triiodothyronine.