Table 3.
Use of Imaging Within 4 Weeks of the Initial Visit for Patients with Acute Low Back Pain, by Primary Care Physician Characteristics
| Physician characteristics | Number of physicians | Number of patients | Radiography | CT/MRI | ||
|---|---|---|---|---|---|---|
| Patients receiving radiography (%) | Adjusted OR (95 % CI)* | Patients receiving CT/MRI (%) | Adjusted OR (95 % CI)* | |||
| All | 3297 | 145,320 | 23.55 | 8.10 | ||
| Specialty | ||||||
| Internal medicine | 1435 | 67,867 | 22.71 | Reference | 8.58 | Reference |
| Family practice | 1862 | 77,453 | 24.29 | 1.08 (1.01–1.17) | 7.67 | 0.87 (0.81–0.94) |
| Gender | ||||||
| Male | 2711 | 123,751 | 23.56 | Reference | 8.25 | Reference |
| Female | 586 | 21,569 | 23.52 | 1.06 (0.97–1.17) | 7.24 | 0.90 (0.82–1.00) |
| Years in practice | ||||||
| Q1 (≤14 years) | 899 | 35,566 | 22.30 | Reference | 7.93 | Reference |
| Q2 (15–22 years) | 844 | 37,459 | 23.99 | 1.07 (0.97–1.18) | 8.14 | 1.04 (0.94–1.15) |
| Q3 (23–29 years) | 743 | 35,454 | 23.52 | 1.02 (0.92–1.13) | 8.01 | 1.00 (0.90–1.11) |
| Q4 (≥30 years) | 811 | 36,841 | 24.35 | 1.12 (1.01–1.24) | 8.30 | 1.08 (0.98–1.20) |
| US-trained | ||||||
| Yes | 2458 | 104,765 | 4.12 | Reference | 8.42 | Reference |
| No | 839 | 40,555 | 22.10 | 0.89 (0.82–0.97) | 7.27 | 0.78 (0.72–0.85) |
| Board certification | ||||||
| Yes | 2558 | 113,605 | 23.83 | Reference | 8.20 | Reference |
| No | 739 | 31,715 | 22.55 | 0.88 (0.81–0.96) | 7.73 | 0.94 (0.81–0.94) |
| Volume of Medicare patients | ||||||
| Q1 (≤276) | 815 | 24,100 | 23.06 | Reference | 6.90 | Reference |
| Q2 (267–394) | 821 | 28,882 | 23.06 | 0.99 (0.89–1.10) | 7.36 | 1.06 (0.95–1.18) |
| Q3 (395–565) | 826 | 36,555 | 23.92 | 1.05 (0.95–1.16) | 8.64 | 1.24 (1.11–1.37) |
| Q4 (≥566) | 835 | 55,783 | 23.76 | 1.06 (0.96–1.18) | 8.61 | 1.26 (1.13–1.40) |
*Estimated from a multilevel model with both patient and physician characteristics. All characteristics listed in Table 2 were adjusted for in this analysis