Table 5.
Odds ratios, follow-up percentage estimates, and 95% confidence intervals for organizational processes significantly associated with 6-month follow-up rates in original and sensitivity-adjusteda multivariable logistic regression models.b,c
| Characteristic | Original Multivariable estimates | Sensitivity-Adjusteda Multivariable estimates | ||
|---|---|---|---|---|
| OR (95% CI) | Follow-up % (95% CI) | OR (95% CI) | Follow-up % (95% CI) | |
| Demand Efficiency Processes | ||||
| Surveillance for 1–2 Adenomas <1 cm – <5 years | 1.00 | 42 (36–48) | 1.00 | 70 (63–76) |
| 5 years | 1.32 (1.02–1.71) | 49 (47–50) | 1.14 (0.80–1.62) | 73 (71–75) |
| 7–10 years | 1.57 (1.11–2.20) | 53 (47–58) | 1.33 (0.84–2.12) | 76 (70–82) |
| Supply Efficiency Processes | ||||
| Gastroenterology notification - by primary care | 1.00 | 47 (45–49) | 1.00 | 72 (69–74) |
| by lab | 1.25 (1.06–1.47) | 52 (49–56) | 1.18 (0.94–1.48) | 75 (71–78) |
| by Gastroenterology | 1.31 (0.99–1.73) | 53 (47–60) | 1.43 (0.98–2.10) | 78 (72–84) |
| Patient-Centered Processes | ||||
| Colonoscopy prep instruction – verbal phone or individual appointment | 1.00 | 43 (40–47) | 1.00 | 68 (64–72) |
| Written only | 1.18 (1.00–1.40) | 48 (45–50) | 1.22 (0.97–1.53) | 72 (69–75) |
| Verbal group appointment or other combined verbal/written method | 1.48 (1.22–1.79) | 53 (50–56) | 1.50 (1.16–1.95) | 76 (73–79) |
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 6-month 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, what type of provider ordered their FOBT, and what type of facility ordered their FOBT) are provided in Supplementary Table 2.