Table 3.
Unadjusted and adjusted echocardiography utilization rates and rate ratios for urban, rural and highly rural VA users from 1999 to 2007
| Urban | Rural | Highly rural | ||||||
|---|---|---|---|---|---|---|---|---|
| Echo Ratea |
RR (95% CI) |
Echo rate* |
RR (95% CI) |
P Value (vs urban) |
Echo rate* |
RR (95% CI) |
P Value (vs urban) |
|
| Unadjusted | 64.1 | 1 (Ref) | 59.1 | 0.92 (0.92–0.93) | < .001 | 63.7 | 0.99 (0.99–1.00) | .02 |
| Adjustedb | 43.1 | 1 (Ref) | 40.1 | 0.93 (0.93–0.94) | < .001 | 42.0 | 0.98 (0.97–0.98) | < .001 |
| Adjustedc | 40.8 | 1 (Ref) | 41.8 | 1.03 (1.02–1.03) | < .001 | 44.9 | 1.10 (1.09–1.11) | < .001 |
a
Echocardiographs per 1,000 VA users per year.
b
Adjusted rate ratios derived using Poisson regression controlling for patient demographics (age, sex and race), VISN, VA priority and comorbid conditions (CHF, myocardial infarction, valvular heart disease, stroke, COPD, cardiac arrhythmias, diabetes, hypertension).
c
Adjusted rate ratios derived using Poisson regression controlling for patient demographics (age, sex and race), VISN, VA priority, comorbid conditions (CHF, myocardial infarction, valvular heart disease, stroke, COPD, cardiac arrhythmias, diabetes, hypertension) and distance to the nearest VAMC.