Table 3.
Multilevel Logistic Regression Model of Time in Practice and Practice Type on GnRH Agonist Overuse
| OR | 95% CI | ||
|---|---|---|---|
| Time in Practice | 0.89 | 0.75, 1.05 | |
| Solo Practitioner (compared to group practice)* | |||
| Yes | 1.65 | 1.34, 2.02 | |
| Missing | 0.82 | 0.55, 1.23 | |
| Physician Gender | 0.92 | 0.45, 1.89 | |
| Board Certification | 1.00 | 0.71, 1.41 | |
| US Training | 0.78 | 0.62, 0.99 | |
| Medical School Affiliation (compared to none)* | |||
| Some | 0.65 | 0.55, 0.77 | |
| Missing | 0.82 | 0.39, 1.73 | |
| Prostate Patient Panel Size (compared to 0–20 patients/year) | |||
| 21–37 | 1.04 | 0.89, 1.21 | |
| ≥38 | 1.00 | 0.83, 1.22 | |
| Proportion Patients Minority (compared to 0%–6.1% minority)* | |||
| 6.2%–19.5% | 0.79 | 0.66, 0.93 | |
| ≥20.0% | 0.81 | 0.66, 1.00 | |
| MMA ImplementationPeriod (compared to Pre-MMA)* | |||
| MMA Period | 0.78 | 0.68, 0.91 | |
| Post-MMA | 0.54 | 0.46, 0.64 | |
| T Stage | 1.36 | 1.19, 1.57 | |
| Grade (compared to Well-differentiated) | |||
| Moderately-differentiated 5–7* | 3.12 | 2.33, 4.17 | |
| Missing | 4.90 | 3.15, 7.60 | |
| Comorbidities (Compared to None) | |||
| 1 | 1.29 | 1.13, 1.48 | |
| 2 | 1.25 | 1.01, 1.55 | |
| ≥3 | 1.46 | 1.14, 1.87 | |
| Patient Age (continuous) | 2.30 | 1.88, 2.82 | |
| Patient Age squared | 1.00 | 0.99, 1.00 | |
| Race/ethnicity (compared to Non-Hispanic White)* | |||
| Non-Hispanic Black | 1.76 | 1.37, 2.27 | |
| Hispanic | 1.41 | 1.12, 1.79 | |
| Other | 1.44 | 1.04, 1.99 | |
| Missing | 1.84 | 1.40, 2.41 | |
| Marital Status (compared to Unmarried) | |||
| Married | 0.91 | 0.79, 1.05 | |
| Missing | 1.64 | 1.34, 1.99 | |
| Pre-treatment Primary Care Use (compared to 0–2 visits in prior year)* | |||
| 3–5 | 1.64 | 1.38, 1.96 | |
| ≥6 | 1.73 | 1.44, 2.10 | |
| Primary Care Consultation | 0.42 | 0.37, 0.48 | |
| Radiation Oncology Consultation | 1.73 | 1.47, 2.05 | |
| Medical Oncology Consultation | 1.03 | 0.76, 1.40 | |
| Urology Consultation | 6.03 | 2.93, 12.41 | |
| Rural Residence | 0.94 | 0.62, 1.44 | |
| Region (compared to Seattle) | |||
| Connecticut | 4.45 | 2.56, 7.74 | |
| Detroit | 2.39 | 1.36, 4.19 | |
| Hawaii | 4.78 | 2.02, 11.30 | |
| Iowa | 3.38 | 1.90, 6.01 | |
| New Mexico | 2.63 | 1.37, 5.04 | |
| California | 2.54 | 1.56, 4.15 | |
| Utah | 1.46 | 0.76, 2.83 | |
| Georgia | 2.44 | 1.27, 4.70 | |
| Kentucky | 3.17 | 1.85, 5.44 | |
| New Jersey | 5.49 | 3.32, 9.08 | |
| Median Income of Patients' Communities (compared to <$35,031) | |||
| $35,051–$46,079 | 0.83 | 0.69, 1.00 | |
| $46,084–$60,668 | 0.83 | 0.66, 1.05 | |
| $60,669–$200,008 | 0.66 | 0.50, 0.88 | |
| Missing | 6.60 | 0.72, 60.11 | |
| Proportion of Patient's Community w/o High-school Education (compared to <9.7%) | |||
| 9.7%–15.5% | 1.18 | 0.98, 1.43 | |
| 15.5%–25.2% | 1.24 | 0.99, 1.55 | |
| 25.2%–100% | 1.17 | 0.89, 1.54 | |
| Missing | 0.11 | 0.01, 0.99 | |
| Constant | 0.00 | 0.00, 0.00 | |
N=12,943 patients; 2,138 urologists
*
Constructs tested for joint significance by likelihood ratio test of nested models:
- Solo practitioner— X2=574.55, p<0.001
- Medical school affiliation—X2=24.36, p<0.001
- Proportion patients minority— X2=7.90, p=0.019
- MMA implementation period — X2=59.46, p<0.001
- Race/ethnicity— X2=39.33, p<0.001