Table 4.
Willingness to Participate in ACOs (0 to 10): Regression Coefficients From GEE Model.a
| Model 1 | Model 2 (With Interaction Effects) | |||||||
|---|---|---|---|---|---|---|---|---|
| Coefficients | Bootstrap Std Err | 95% CI | P Value | Coefficients | Bootstrap Std Err | 95% CI | P Value | |
| Constant | 5.014 | 0.666 | 3.709 to 6.318 | <.001 | 5.418 | 0.720 | 4.007 to 6.830 | <.001 |
| Clinical infrastructure | 0.655 | 0.448 | −0.222 to 1.534 | .143 | .541 | 0.466 | −0.372 to 1.455 | .245 |
| Percentage of older people in county (2011) | 4.301 | 6.584 | −8.603 to 17.206 | .514 | 3.422 | 7.388 | −11.058 to 17.903 | .643 |
| RHC size | 0.402 | 0.155 | 0.097 to 0.707 | .010 | 0.368 | 0.146 | 0.082 to 0.655 | .012 |
| Control type | ||||||||
| For-profitb | 1 | |||||||
| Nonprofit | 1.271 | 0.660 | −0.022 to 2.565 | .054 | 1.499 | 0.655 | 0.215 to 2.783 | .022 |
| Government based | −0.538 | 1.038 | −2.572 to 1.497 | .604 | −0.939 | 1.068 | −3.032 to 1.154 | .379 |
| Technology infrastructure | ||||||||
| With EMR systemb | 1 | 1 | ||||||
| Without EMR but is willing to adopt | −0.357 | 0.608 | −1.548 to 0.835 | .557 | −1.561 | 1.117 | −3.752 to 0.630 | .163 |
| Without EMR but no willingness to adopt | −1.710 | 2.229 | −6.079 to 2.658 | .443 | −0.057 | 2.477 | −4.912 to 4.798 | .982 |
| Rurality | ||||||||
| Urbanb | 1 | 1 | ||||||
| Large rural | −1.307 | 0.847 | −2.967 to 0.352 | .123 | −1.397 | 1.005 | −3.367 to 0.573 | .165 |
| Small rural | −1.274 | 0.746 | −2.737 to 0.189 | .088 | −1.950 | 0.899 | −3.712 to −0.187 | .030 |
| Isolated | 0.375 | 0.852 | −1.295 to 2.045 | .660 | 0.430 | 1.007 | −1.545 to 2.406 | .699 |
| Rurality × IT | ||||||||
| With EMR system × urbanb | 1 | |||||||
| Large rural × without EMR but is willing to adopt | 1.990 | 1.859 | −1.653 to 5.634 | .284 | ||||
| Large rural × without EMR but no willingness to adopt | −4.902 | 2.710 | −10.214 to 0.410 | .070 | ||||
| Small rural × without EMR but is willing adopt | 2.523 | 1.230 | −0.021 to 5.066 | .052 | ||||
| Isolated × without EMR but is willing to adopt | −1.363 | 1.634 | −4.572 to 1.844 | .405 | ||||
| Isolated × without EMR but no willingness to adopt | 0 (empty) | |||||||
Abbreviation: CI, confidence interval; ACO, Accountable Care Organization; RHC, Rural Health Clinic; GEE, generalized estimating equation; Sd Err, standard error.
aThe “small rural × without EMR but no willingness to adopt” group is omitted because of collinearity.
bindicates a reference group.