Table 4.
Multivariate Logistic Regression of the Impact of Sociodemographic, Hospital, Distance, and Contextual Characteristics on the Receipt of Guideline Concordant Treatment for Stage I - III Colorectal Cancer Patients Living in Appalachian Counties in 4 States, 2006- 2008
| Chemotherapy (n=561) |
Nodal Assessment (n=2932) |
Radiation (n=184)b | ||||
|---|---|---|---|---|---|---|
|
| ||||||
| OR | 95%CI | OR | 95%CI | OR | 95%CI | |
| Age in years | 0.918* | 0.879 – 0.959 | 0.90* | 0.841 – 0.974 | ||
| Gender: Female vs. Male | 1.207a | 1.016 – 1.435 | ||||
| Race: White vs. Other | 1.637a | 1.004 – 2.668 | ||||
|
| ||||||
| Grade Diff: Well vs. Poor | 0.990 | 0.687 – 1.425 | ||||
| Grade: Diff. Moderate. vs. Poor | 0.824 | 0.647 – 1.050 | ||||
|
| ||||||
| Stage: I vs. III | 0.505a | 0.398 – 0.641 | ||||
| Stage: II vs. III | 0.784a | 0.633 – 0.971 | ||||
|
| ||||||
| Comorbidity Index (vs. None) | ||||||
| Mild | 1.442 | 0.812 – 2.559 | ||||
| Moderate | 1.091 | 0.539 – 2.209 | ||||
| Severe | 0.902 | 0.469 – 1.737 | ||||
|
| ||||||
| ACE-27 Comorbidities | ||||||
| AMI | 0.658 | 0.323 – 1.339 | ||||
| Congestive heart failure | 0.699 | 0.384 – 1.270 | ||||
| Dementia | 0.107* | 0.013 – 0.898 | ||||
| Respiratory Diseases | 0.713 | 0.453 – 1.121 | ||||
| Diabetes | 0.780a | 0.649 – 0.938 | ||||
| Log Tumorsize | 1.872a | 1.608 – 2.179 | ||||
|
| ||||||
| Hospital Bedsize Category (vs. 500+) | ||||||
| <50 | 1.700 | 0.863 – 3.347 | ||||
| 50 - 100 | 1.427 | 0.829 – 2.459 | ||||
| 100 - 200 | 1.036 | 0.664 – 1.618 | ||||
| 200 - 500 | 0.814 | 0.575 – 1.152 | ||||
|
| ||||||
| Hospital COC designation (vs. None) | ||||||
| Hospital Cancer Program | 2.405a | 1.763 – 3.281 | ||||
| Comprehensive Cancer Program | 2.136a | 1.593 – 2.864 | ||||
| NCI designated Cancer Program | 2.292a | 1.198 – 4.383 | ||||
| Network Cancer Program | 1.794 | 0.691 – 4.661 | ||||
| Teaching Hospital | 2.069a | 1.332 – 3.212 | ||||
| Facility Radiation (yes vs. no) | 1.026 | 0.789 – 1.335 | ||||
|
| ||||||
| Facility Surgical Volume (versus Q4) | ||||||
| Quartile 1 | 0.344a | 0.223 – 0.530 | ||||
| Quartile 2 | 0.345a | 0.232 – 0.512 | ||||
| Quartile 3 | 0.667a | 0.474 – 0.939 | ||||
| Other MD Specialty (vs. Colorectal Surgery) | 0.917 | 0.652 – 1.292 | ||||
|
| ||||||
| Surgery Provider Volume (vs. Q4) | ||||||
| Quartile 1 (lowest) | 0.963 | 0.716 – 1.295 | ||||
| Quartile 2 | 0.985 | 0.744 – 1.304 | ||||
| Quartile 3 | 0.867 | 0.648 – 1.160 | ||||
|
| ||||||
| Provider Graduation Year | 1.010a | 1.001 – 1.019 | ||||
| Metropolitan vs. non-metropolitan | 0.980 | 0.756 – 1.270 | ||||
| Year of diagnosis | ||||||
| 2007 | 1.668a | 1.361 - 2.045 | 1.281 | 0.609 – 2.694 | ||
| 2008 | 1.902a | 1.532 - 2.361 | 0.561 | 0.269 – 1.169 | ||
a
F-statistic, P < .05
b
Race and COC designation removed from analysis because of excessively unbalanced distributions and otherreasons.