Table 2.
Characteristics of Medicare beneficiaries with uncomplicated low back pain and their primary care physicians, and the rapidity and modality of imaging that they received
| Rapidity of imaging | Imaging modality | ||||||
|---|---|---|---|---|---|---|---|
| N (%) Total = 35,039 |
Within 28 days, Percent of beneficiaries (N = 9,637) |
Within 29-180 days Percent of beneficiaries (N =1,657) |
None within 180 days Percent of beneficiaries (N = 23,745) |
Any CT/MRI Percent of beneficiaries (N = 3,598) |
Radiograph only Percent of beneficiaries (N = 7,696) |
None within 180 days Percent of beneficiaries (N = 23,245) |
|
|
Characteristics of
beneficiaries |
|||||||
| Age | |||||||
| 65-74 | 19,856 (56.7) | 28.0 | 4.8 | 67.2 | 10.8 | 22.0 | 67.2 |
| 75-84 | 12,345 (35.2) | 29.6 | 4.7 | 65.7 | 10.3 | 24.0 | 65.7 |
| >84 | 2,838 (8.1) | 30.5a | 2.5c | 66.9 | 8.5a | 24.6 | 66.9 |
| Female | 24,281 (69.3) | 28.9 | 4.8 | 66.3 | 10.2 | 23.5 | 66.3 |
| Male | 10,758 (30.7) | 28.4 | 4.1 | 67.5 | 11.0 | 21.5a | 67.5 |
| Race | |||||||
| White | 30,746 (87.8) | 29.7 | 4.7 | 65.6 | 10.8 | 23.6 | 65.6 |
| Black | 2,626 (7.5) | 24.8c | 4.5 | 70.8c | 9.1a | 20.1b | 70.8c |
| Other | 1,667 (4.8) | 18.9c | 2.7c | 78.4c | 7.2a | 14.4c | 78.4c |
| Not Medicaid eligible | 30,664 (87.5) | 29.7 | 4.7 | 65.5 | 11.0 | 23.5 | 65.5 |
| Medicaid eligible | 4,375 (12.5) | 22.7c | 3.8a | 73.5c | 7.3c | 19.2b | 73.5c |
| Charlson index | |||||||
| No comorbidities | 31,684 (90.4) | 28.6 | 4.6 | 66.8 | 10.3 | 22.9 | 66.8 |
| 1 comorbidity | 1,711 (4.9) | 31.7 | 4.5 | 63.8 | 14.0b | 22.2 | 63.8 |
| ≥2 comorbidities | 1,644 (4.7) | 28.4 | 5.6 | 66.0 | 10.5 | 23.5 | 66.0 |
| Median household income in zip code |
|||||||
| Above county median | 17,693 (50.5) | 29.5 | 5.0 | 65.5 | 11.3 | 23.2 | 65.5 |
| Below county median | 16,599 (47.5) | 28.0a | 4.2 | 67.8c | 9.8b | 22.5 | 67.8c |
|
Characteristics of the
PCP and his or her practice |
|||||||
| Specialty | |||||||
| General internal medicine |
16,835 (48.0) | 31.1 | 4.5 | 64.4 | 11.2 | 24.4 | 64.4 |
| Family/general practice |
18,204 (52.0) | 26.5c | 4.8 | 68.8c | 9.8a | 21.4b | 68.8c |
| Years in practice | |||||||
| 0-10 | 9,452 (27.0) | 32.0 | 4.7 | 65.0 | 10.7 | 24.3 | 65.0 |
| 11-20 | 12,574 (35.9) | 29.0 | 4.7 | 66.3 | 10.1 | 23.6 | 66.3 |
| >20 | 13,013 (37.1) | 27.4 | 4.5 | 68.1a | 10.7 | 21.2b | 68.1a |
| Board certified | 30,640 (87.5) | 29.0 | 4.7 | 66.3 | 10.6 | 23.1 | 66.3 |
| Not board certified | 4,320 (12.3) | 26.5 | 4.0 | 69.5 | 9.5 | 21.0 | 69.5 |
| Medical school outside U.S./Canada |
5,958 (17.0) | 26.2 | 4.2 | 69.6 | 8.9 | 21.5 | 69.6 |
| U.S./Canadian medical school |
29,071 (83.0) | 29.3a | 4.7 | 66.0a | 10.9b | 23.2 | 66.0a |
| Practice type | |||||||
| Solo/2-person | 15,452 (44.1) | 25.3 | 4.5 | 70.2 | 10.0 | 19.7 | 70.3 |
| Small group, 3-10 | 7,104 (20.3) | 31.6c | 4.3 | 64.1c | 10.6 | 25.3c | 64.1c |
| Medium group, 11-50 | 2,877 (8.2) | 37.6c | 5.1 | 67.3c | 10.3 | 32.4c | 57.3c |
| Large group, >50 | 1,366 (3.9) | 33.9c | 4.9 | 61.1c | 11.2 | 27.7c | 61.1c |
| Medical school | 822 (2.4) | 25.0 | 4.3 | 70.7 | 9.3 | 20.0 | 70.7 |
| Hospital practice/Other |
6,889 (19.7) | 28.4c | 4.9 | 66.7c | 11.3 | 21.9a | 66.7c |
| Group/staff HMO | 529 (1.5) | 23.9 | 5.6 | 70.5 | 10.7 | 18.8 | 70.5 |
| Practice revenue derived from Medicaid |
|||||||
| 0-5% | 17,824 (50.9) | 30.7 | 4.5 | 64.8 | 11.2 | 24.0 | 64.8 |
| 6-15% | 10,908 (31.1) | 29.3 | 4.9 | 65.8 | 10.5 | 23.7 | 65.8 |
| >15% | 6,307 (18.0) | 23.8c | 34.5 | 71.7c | 8.9b | 19.4c | 71.7c |
| Practice revenue derived from capitation |
|||||||
| None | 16,659 (47.5) | 28.6 | 4.8 | 66.7 | 10.9 | 22.5 | 66.6 |
| 1-10% | 7,489 (21.4) | 31.1 | 4.4 | 64.5 | 11.1 | 24.5 | 64.5 |
| 11-25% | 4,330 (12.4) | 29.0 | 5.1 | 65.8 | 10.2 | 23.9 | 65.8 |
| >25% | 6,561 (18.7) | 26.4 | 3.9 | 69.7 | 8.8b | 21.5 | 69.7 |
| Practice ownership | |||||||
| Full owner | 14,830 (42.3) | 27.3 | 4.7 | 68.0 | 10.3 | 21.7 | 65.5 |
| Part-owner | 9,298 (26.5) | 30.1a | 4.3 | 65.6 | 10.0 | 24.4a | 65.6 |
| Employed | 10,911 (31.1) | 29.8a | 4.7 | 65.5 | 11.1 | 23.4 | 68.0 |
| Financial incentives | |||||||
| None of three types of incentives |
2,828 (8.1) | 31.0 | 4.9 | 64.1 | 10.5 | 25.4 | 64.1 |
| Only clinical quality incentives |
63 (0.2) | 26.1 | 3.0 | 70.9 | 1.4c | 27.8 | 70.9 |
| Only patient satisfaction incentives |
122 (0.4) | 58.0c | 5.9 | 36.1c | 17.1c | 46.9c | 36.1c |
| Only productivity incentives |
13,240 (37.8) | 30.0 | 4.6 | 65.4 | 10.6 | 24.1 | 65.4 |
| Clinical quality and patient satisfaction, but not productivity incentives |
144 (0.4) | 18.4b | 3.4 | 78.3b | 10.6 | 11.1b | 78.3b |
| Clinical quality and productivity, but not patient satisfaction incentives |
1,005 (2.9) | 29.9 | 4.7 | 65.4 | 11.6 | 22.9 | 65.4 |
| Patient satisfaction and productivity incentives, but not clinical quality incentives |
2,128 (6.1) | 33.6 | 3.7 | 62.7 | 11.1 | 26.2 | 62.7 |
| All three types of incentives |
3,200 (9.1) | 26.1 | 5.3 | 68.7 | 10.1 | 21.2 | 68.7 |
| Not asked questions on specific incentives |
11,902 (34.0) | 25.1a | 4.5 | 70.5b | 10.0 | 19.6 | 70.5b |
Unweighted counts and weighted percentages are based on analysis of claims in years 2000-2002 and 2004-2006 for 35,039 fee-for-service Medicare beneficiaries treated by one of 4,567 primary care physician respondents to the Community Tracking Study Physician Survey.
a
p-value<0.05
b
p-value<0.01
c
p-value<0.001 for comparisons to the first (referent) category for each patient, physician, or practice characteristic.