TABLE 3.
Adjusted ORs (95% CI) for Receipt of Colonoscopy, FOBT, and Pap Test
| Colonoscopy N = 769,729 | P | FOBT N = 753,868 | P | Pap Test N=2,136,511 | P | |
|---|---|---|---|---|---|---|
| Reimbursement variablesa | ||||||
| State median reimbursement for cancer screening test | 1.016 (1.011-1.027) | <.001 | NA | 0.992 (0.989-0.995) | <.001 | |
| State median reimbursement for an office visit | 1.069 (1.060-1.078) | <.001 | 1.087 (1.077-1.097) | <.001 | 1.023 (1.020-1.026) | <.001 |
| Sociodemographic and other variables | ||||||
| Ageb | 1.053 (0.975-1.137) | .19 | 1.177 (1.077-1.287) | <.001 | 0.982 (0.980-0.984) | <.001 |
| Sex | ||||||
| Female | Reference | Reference | Reference | |||
| Male | 0.829 (0.812-0.847) | <.001 | 0.666 (0.649-0.683) | <.001 | NA | |
| Race/ethnicity | ||||||
| White | Reference | Reference | Reference | |||
| Black | 0.867 (0.846-0.890) | <.001 | 0.834 (0.809-0.859) | <.001 | 1.078 (1.070-1.087) | <.001 |
| Hispanic | 1.043 (1.006-1.081) | .02 | 1.226 (1.178-1.276) | <.001 | 1.163 (1.149-1.176) | <.001 |
| Other | 0.957 (0.928-0.986) | .01 | 1.256 (1.216-1.296) | <.001 | 1.039 (1.027-1.051) | <.001 |
| No. of chronic conditions | ||||||
| 0 | Reference | Reference | Reference | |||
| 1 | 2.193 (2.120-2.268) | <.001 | 2.049 (1.972-2.128) | <.001 | 1.554 (1.541-1.567) | <.001 |
| ≥2 | 2.956 (2.864-3.051) | <.001 | 2.537 (2.449-2.628) | <.001 | 1.731 (1.714-1.748) | <.001 |
| Residence | ||||||
| Large metropolitan area | Reference | Reference | Reference | |||
| Small metropolitan area | 1.092 (1.064-1.121) | <.001 | 1.066 (1.035-1.097) | <.001 | 1.123 (1.114-1.133) | <.001 |
| Non metropolitan area adjacent to metropolitan area | 1.074 (1.040-1.109) | <.001 | 0.997 (0.962-1.034) | .88 | 1.172 (1.160-1.184) | <.001 |
| Nonmetropolitan area not adjacent to metropolitan area | 1.021 (0.983-1.061) | .28 | 0.878 (0.839-0.918) | <.001 | 1.181 (1.167-1.196) | <.001 |
| No. of inpatient stays | 1.084 (1.074-1.093) | <.001 | 1.069 (1.060-1.079) | <.001 | 0.905 (0.900-0.910) | <.001 |
| Medicaid eligibility category | ||||||
| Parents | Reference | Reference | Reference | |||
| Blind/disabled | 0.984 (0.947-1.022) | .39 | 1.191 (1.138-1.246) | <.001 | 0.745 (0.738-0.751) | <.001 |
| Medically needy | 1.073 (1.009-1.142) | .03 | 0.965 (0.892-1.044) | .37 | 0.930 (0.918-0.943) | <.001 |
| State BRFSS cancer screening rate | 1.021 (1.018-1.024) | <.001 | 1.043 (1.040-1.046) | <.001 | 1.055 (1.053-1.057) | <.001 |
| State Medicaid variables | ||||||
| Income eligibility | ||||||
| More restrictive | Reference | Reference | Reference | |||
| Less restrictive | 0.995 (0.971-1.019) | .66 | 0.857 (0.835-0.880) | <.001 | 1.056 (1.047-1.066) | <.001 |
| Financial assets | ||||||
| More restrictive | Reference | Reference | Reference | |||
| Less restrictive | 1.074 (1.045-1.103) | <.001 | 0.914 (0.885-0.943) | <.001 | 1.122 (1.114-1.131) | <.001 |
| Frequency of Medicaid renewal | ||||||
| 12 mo | Reference | Reference | Reference | |||
| <12 mo | 1.016 (0.988-1.044) | .27 | 1.034 (1.003-1.067) | .03 | 0.981 (0.972-0.990) | <.001 |
| Requires physician copayment | ||||||
| No | Reference | Reference | Reference | |||
| Yes | 0.939 (0.918-0.959) | <.001 | 1.142 (1.114-1.170) | <.001 | 0.944 (0.937-0.951) | <.001 |
Abbreviations: 95% CI, 95% confidence interval; BRFSS, Behavioral Risk Factor Surveillance System; FOBT, fecal occult blood test; NA, not applicable; OR, odds ratio; Pap, Papanicolaou.
a
ORs for the reimbursement variables were scaled by the dollar amount equal to 20% of the national median reimbursement for that screening test/office visit.
b
Age-squared (ie, age times age) was also included in all regression models (results not shown).