Table 4.
Odds ratios, 95% confidence intervals, and follow-up percentage estimates for organizational structures and processes derived from the original and sensitivity-adjusteda multivariable regression models for 60-day follow-up rate outcome measure.b,c
| Characteristic | Original Multivariable estimates | Sensitivity-adjusteda Multivariable estimates. | ||
|---|---|---|---|---|
| OR (95% CI) | Follow-up % (95% CI) | OR (95% CI) | Follow-up % (95% CI) | |
| ORGANIZATIONAL STRUCTURES | ||||
| Resources | ||||
| Colonoscopy appointment availability - Is a key barrier | 1.00 | 26 (23–30) | 1.00 | 48 (43–52) |
| Is not a key barrier | 1.43 (1.09–1.90) | 34 (30–38) | 1.48 (1.14–1.92) | 58 (53–62) |
| Feedback | ||||
| Primary Care feedback - Aggregate | 1.00 | 24 (16–34) | 1.00 | 48 (37–60) |
| None | 1.09 (0.65–1.82) | 26 (22–29) | 0.96 (0.59–1.58) | 47 (43–51) |
| Individual, infrequent | 1.52 (0.85–2.71) | 32 (25–40) | 1.32 (0.75–2.31) | 55 (47–63) |
| Individual, frequent | 1.79 (1.02–3.16) | 36 (30–43) | 1.71 (0.99–2.97) | 61 (54–68) |
| ORGANIZATIONAL PROCESSES | ||||
| Demand Efficiency Processes | ||||
| Information on colonoscopy consult - Contraindications | 1.00 | 25 (22–29) | 1.00 | 48 (44–53) |
| Indication | 1.49 (1.10–2.02) | 33 (28–40) | 1.30 (0.96–1.74) | 55 (49–61) |
| Neither | 1.48 (1.07–2.05) | 33 (27–40) | 1.19 (0.86–1.63) | 53 (46–60) |
| Supply Efficiency Processes | ||||
| Gastroenterology notification – by Primary Care | 1.00 | 26 (24–30) | 1.00 | 48 (45–52) |
| by lab | 1.36 (0.97–1.90) | 33 (26–40) | 1.24 (0.89–1.73) | 54 (46–61) |
| by Gastroenterology | 1.85 (1.17–2.91) | 40 (30–50) | 1.82 (1.17–2.83) | 63 (53–72) |
Excluding patients who may not have been appropriate for colorectal cancer screening (age <45 or >85, documentation of limited life expectancy in the medical record, or colonoscopy in the prior 10 years), and treating patients who refused colonoscopy or chose to pursue colonoscopy in the private sector as having adequate follow-up.
Bold odds ratios are significant at p <0.05
Odds ratios for the individual-level factors controlled for in the 60-day model (age, race, residence, drive time to the nearest VHA specialty care facility, personal history of colorectal polyps or benign neoplasms, Charlson comorbidity score for the 1 year prior to the FOBT+ result, mental health diagnoses, whether the FOBT was ordered by their primary care provider, and what type of facility ordered their FOBT) are provided in Supplementary Table 2.