Table 3.
Provider- and Site-Level Predictors of Appropriate Testing in New Testosterone Patients (n = 99,045)
| Variable | Number of Patients (%) | Fully Adjusted Modelsa Adjusted for Clustering by Provider and Site Odds Ratio (95% CI) |
||
|---|---|---|---|---|
| At Least 1 Low T (n = 78,525) | At Least 2 Low T (n = 18,375) | At Least 2 Low T in Morning (n = 5,379) | ||
| Provider age, y | ||||
| 22–30 | 1,553 (1.6) | 0.93 (0.79–1.09) | 1.46b (1.23–1.73) | 1.29 (0.98–1.68) |
| 31–40 | 15,194 (15.3) | 0.98 (0.90–1.06) | 1.23b (1.12–1.36) | 1.30b (1.12–1.50) |
| 41–50 | 29,399 (29.7) | 0.99 (0.92–1.07) | 1.12b (1.03–1.22) | 1.14 (1.00–1.30) |
| 51–60 | 38,206 (38.6) | 1.03 (0.96–1.10) | 1.11b (1.03–1.20) | 1.12 (1.00–1.26) |
| 61+ | 14,693 (14.8) | ref. | ref. | ref. |
| Years in VA | ||||
| 0, 1 | 16,150 (16.3) | 0.96 (0.89–1.04) | 0.79b (0.73–0.86) | 0.82b (0.72–0.94) |
| 2–5 | 27,090 (27.4) | 0.99 (0.92–1.06) | 0.85b (0.79–0.92) | 0.95 (0.85–1.07) |
| 6–10 | 25,127 (25.4) | 1.03 (0.96–1.10) | 0.86b (0.79–0.92) | 0.91 (0.81–1.03) |
| 11–15 | 13,295 (13.4) | 0.96 (0.89–1.04) | 0.91 (0.84–0.99) | 1.06 (0.93–1.20) |
| 16 or more | 17,383 (17.6) | ref. | ref. | ref. |
| Male sex | ||||
| Yes | 53,590 (54.1) | 0.88b (0.84–0.93) | 0.87b (0.82–0.93) | 0.88b (0.81–0.96) |
| Provider type | ||||
| MD, primary care | 70,351 (71.0) | ref. | ref. | ref. |
| MD, endocrinology | 912 (0.9) | 1.29 (1.01–1.65) | 2.09b (1.63–2.67) | 2.14b (1.54–2.97) |
| MD, urology | 205 (0.2) | 0.98 (0.65–1.47) | 1.37 (0.88–2.14) | 0.79 (0.36–1.73) |
| MD, other specialty | 7,300 (7.4) | 1.32b (1.21–1.43) | 1.32b (1.21–1.44) | 1.12 (0.98–1.27) |
| PA, primary care | 4,016 (4.1) | 0.83b (0.73–0.93) | 0.87 (0.75–1.00) | 1.01 (0.82–1.23) |
| PA, non–primary care | 1,411 (1.4) | 1.20 (0.99–1.45) | 1.19 (0.97–1.46) | 1.30 (0.97–1.73) |
| Nurse practitioner | 14,526 (14.7) | 0.92 (0.85–0.98) | 0.97 (0.89–1.05) | 1.02 (0.90–1.15) |
| Pharmacist | 243 (0.2) | 1.04 (0.72–1.49) | 0.89 (0.60–1.31) | 0.73 (0.38–1.42) |
| Other credentials | 81 (0.1) | 0.72 (0.42–1.24) | 0.87 (0.46–1.66) | 0.60 (0.18–2.01) |
| Region | ||||
| Northeast (n = 24)c | 9,414 (9.5) | ref. | ref. | ref. |
| Midwest (n = 27)c | 19,588 (19.8) | 1.36b (1.26–1.47) | 0.90 (0.83–0.99) | 0.88 (0.78–1.01) |
| South (n = 46)c | 44,303 (44.7) | 1.28b (1.19–1.37) | 0.86b (0.79–0.93) | 0.80b (0.72–0.90) |
| West (n = 32)c | 25,740 (26.0) | 1.38b (1.28–1.49) | 0.97 (0.90–1.06) | 0.85 (0.75–0.97) |
| Whether patient received any care in VA at outpatient clinic outside of hospital | ||||
| Yes | 75,103 (75.8) | 0.97b (0.93–1.02) | 0.91b (0.87–0.96) | 0.83b (0.77–0.90) |
| Complexity group | ||||
| Category 1a (most complex) | 44,184 (44.6) | 1.10b (1.03–1.17) | 1.20b (1.12–1.29) | 1.33b (1.18–1.49) |
| Category 1b | 12,007 (12.1) | 0.95 (0.88–1.03) | 1.07 (0.98–1.17) | 1.00 (0.86–1.16) |
| Category 1c | 20,112 (20.3) | 1.00 (0.93-1.08) | 1.10 (1.02–1.20) | 1.23b (1.08–1.41) |
| Category 2 | 11,650 (11.8) | 0.82b (0.76–0.89) | 0.98 (0.89–1.07) | 1.17 (1.01–1.35) |
| Category 3 (least complex) | 11,092 (11.2) | ref. | ref. | ref. |
Abbreviation: PA, physician assistant.
a
Each fully adjusted model uses all provider and site characteristics specified on the table.
b
Odds ratio differs from the reference group; that is, patients without the specified factor, at the level of P < 0.01. All other odds ratios do not differ from the reference group at the 0.01 level.
c
Total number of sites per region.