Table 3. Multivariable analyses of the associations between provider continuity measures and end-of-life care.
| End of life care measures | ||||
| Hospitalized1 OR (95% CI) | ICU1 OR (95% CI) | Chemotherapy1 OR (95% CI) | Hospice2 OR (95% CI) | |
| PCP | ||||
| Saw a PCP | ||||
| No | 0.82 (0.79,0.84) | 0.88 (0.84,0.93) | 0.77 (0.73,0.81) | 0.84 (0.82,0.87) |
| Yes | ref | ref | ref | ref |
| Number of PCPs seen | ||||
| 0 | 0.82 (0.80,0.85) | 0.89 (0.84,0.94) | 0.77 (0.72,0.81) | 0.87 (0.84,0.90) |
| 1 | ref | ref | ref | ref |
| > 1 | 1.04 (1.00,1.08) | 1.03 (0.97,1.10) | 1.00 (0.94,1.06) | 1.10 (1.06,1.15) |
| Total visits to PCP | ||||
| 0 | 0.86 (0.83,0.89) | 0.91 (0.85,0.96) | 0.78 (0.73,0.82) | 0.85 (0.81,0.88) |
| 1–3 | ref | ref | ref | ref |
| 4–7 | 1.08 (1.04,1.13) | 0.99 (0.93,1.06) | 1.03 (0.97,1.10) | 1.02 (0.97,1.06) |
| >7 | 1.14 (1.08,1.19) | 1.15 (1.07,1.24) | 1.01 (0.94,1.10) | 0.97 (0.92,1.02) |
| Number of visits to assigned PCP | ||||
| 1–3 | ref | ref | ref | ref |
| 4–7 | 1.07 (1.03,1.12) | 1.01 (0.95,1.07) | 1.05 (0.99,1.11) | 1.00 (0.96,1.05) |
| >7 | 1.16 (1.09,1.22) | 1.17 (1.08,1.26) | 1.02 (0.94,1.12) | 0.91 (0.86,0.96) |
| Time exposure method continuity of PCP3 | ||||
| No | 0.92 (0.83,1.02) | 0.93 (0.79,1.09) | 1.09 (0.94,1.26) | 0.94 (0.84,1.04) |
| Yes | ref | ref | ref | ref |
| Any Provider | ||||
| Saw any provider | ||||
| No | 0.68 (0.65,0.71) | 0.77 (0.72,0.82) | 0.61 (0.57,0.66) | 0.8 (0.76,0.83) |
| Yes | ref | ref | ref | ref |
| Number of any providers seen | ||||
| 0 | 0.72 (0.68,0.75) | 0.81 (0.75,0.86) | 0.67 (0.62,0.72) | 0.83 (0.79,0.87) |
| 1 | ref | ref | ref | ref |
| > 1 | 1.1 (1.07,1.14) | 1.09 (1.04,1.15) | 1.18 (1.12,1.24) | 1.09 (1.05,1.13) |
| Total visits to any provider | ||||
| 0 | 0.75 (0.71,0.78) | 0.83 (0.77,0.89) | 0.67 (0.62,0.72) | 0.81 (0.77,0.85) |
| 1–3 | ref | ref | ref | ref |
| 4–7 | 1.12 (1.07,1.17) | 1.04 (0.98,1.11) | 1.10 (1.04,1.18) | 1.06 (1.02,1.11) |
| >7 | 1.26 (1.21,1.32) | 1.24 (1.16,1.32) | 1.23 (1.15,1.32) | 1.01 (0.96,1.05) |
| Number of visits to assigned provider | ||||
| 1–3 | ref | ref | ref | ref |
| 4–7 | 1.13 (1.09,1.18) | 1.08 (1.02,1.15) | 1.1 (1.04,1.16) | 1 (0.96,1.04) |
| >7 | 1.25 (1.19,1.31) | 1.26 (1.17,1.35) | 1.12 (1.04,1.2) | 0.89 (0.84,0.93) |
| Time exposure method continuity of any provider3 | ||||
| No | 0.92 (0.83,1.02) | 0.88 (0.74,1.05) | 0.97 (0.84,1.14) | 0.86 (0.77,0.96) |
| Yes | ref | ref | ref | ref |
ICU, intensive care unit; PCP, primary care physician; OR, odds ratio. CI, confidence interval. All models adjusted for age at diagnosis, gender, race, low socioeconomic status, SEER site, diagnosis year, survival time, Charlson comorbidity score and number of times hospitalized in the 13–24 months prior to diagnosis. Bolded values indicate p < 0.05.
3 = Time exposure method of continuity is defined as having visited the same physician twice within any eight months over the two years prior to the diagnosis of lung cancer