Table 4.
Effects of Medicare Policy and Covariates on Utilization (USPSTF based Measures). (Odds Ratio, Confidence Interval, P-value)
| Annual Mammogram (Women > = 40) | Biennial Pap Smear (All women) | Colonoscopy (All men and women > = 50) | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Odds Ratio | 95% Confidence Interval | P-value | Odds Ratio | 95% Confidence Interval | P-value | Odds Ratio | 95% Confidence Interval | P-value | |
| Transition: 2011–2012 | 1.04 | 0.80–1.35 | 0.78 | 0.70 | 0.21–2.37 | 0.57 | 1.05 | 0.83–1.34 | 0.68 |
| Post-policy: 2013 | 1.15 | 0.76–1.75 | 0.50 | 0.52 | 0.06–4.24 | 0.54 | 1.01 | 0.71–1.44 | 0.95 |
| Continuous Year | 0.92 | 0.84–1.01 | 0.09 | 1.16 | 0.67–2.01 | 0.59 | 1.00 | 0.93–1.07 | 0.96 |
| Having a private supplemental insurance | 2.34 | 1.76–3.11 | < 0.001 | 2.63 | 1.01–6.84 | 0.05 | 1.95 | 1.59–2.40 | < 0.001 |
| Having usual source of care | – | – | – | – | – | – | – | – | – |
| Income level: Poor (Ref: High Income) | 0.86 | 0.56–1.33 | 0.50 | 1.18 | 0.21–6.70 | 0.85 | 1.11 | 0.78–1.57 | 0.56 |
| Income level: Near poor | 1.25 | 0.95–1.66 | 0.11 | 1.62 | 0.44–5.89 | 0.47 | 1.04 | 0.84–1.27 | 0.73 |
| Income level: Middle | 1.17 | 0.96–1.44 | 0.13 | 3.86 | 1.26–11.85 | 0.02 | 1.14 | 0.99–1.31 | 0.06 |
| Education level: Less than high school (Ref: College) | 0.52 | 0.28–0.95 | 0.04 | 1.42 | 0.21–9.65 | 0.72 | 1.03 | 0.76–1.41 | 0.85 |
| Education level: High school | 0.93 | 0.76–1.14 | 0.48 | 1.04 | 0.42–2.55 | 0.93 | 0.94 | 0.83–1.07 | 0.36 |
| Current smoker | 0.68 | 0.51–0.91 | 0.01 | 1.15 | 0.51–2.60 | 0.74 | 0.76 | 0.62–0.94 | 0.01 |
| Living in metro area | 1.04 | 0.84–1.28 | 0.73 | 0.81 | 0.33–2.00 | 0.65 | 1.03 | 0.90–1.17 | 0.69 |
| Female | – | – | – | – | – | – | 1.01 | 0.89–1.14 | 0.90 |
| Being married | 1.56 | 1.26–1.93 | < 0.001 | 0.59 | 0.23–1.54 | 0.28 | 1.14 | 0.99–1.31 | 0.06 |
| Age | 1.03 | 0.99–1.06 | 0.13 | 0.98 | 0.95–1.02 | 0.27 | 1.00 | 0.98–1.02 | 0.99 |
| Race/Ethnicity: Hispanic (Ref: Non-Hispanic White) | 0.86 | 0.49–1.50 | 0.59 | 3.11 | 0.65–14.88 | 0.16 | 0.87 | 0.61–1.24 | 0.43 |
| Race/Ethnicity: Non-Hispanic Black | 1.26 | 0.88–1.81 | 0.21 | 2.21 | 0.81–6.07 | 0.12 | 1.34 | 1.08–1.66 | 0.01 |
| Race/Ethnicity: Non-Hispanic other race | 0.70 | 0.44–1.10 | 0.12 | 4.21 | 1.34–13.23 | 0.01 | 0.82 | 0.54–1.24 | 0.34 |
| Disabled | 1.31 | 0.80–2.14 | 0.29 | 2.78 | 0.52–14.73 | 0.23 | 0.85 | 0.63–1.15 | 0.30 |
| Self-reported health: Very good (Ref: Excellent) | 1.08 | 0.86–1.35 | 0.53 | 5.55 | 0.89–34.74 | 0.07 | 1.04 | 0.87–1.23 | 0.68 |
| Self-reported health: Good | 1.01 | 0.79–1.29 | 0.93 | 5.60 | 1.02–30.79 | 0.05 | 1.14 | 0.95–1.36 | 0.16 |
| Self-reported health: Fair | 0.86 | 0.63–1.17 | 0.33 | 7.67 | 1.43–41.24 | 0.02 | 1.19 | 0.95–1.49 | 0.12 |
| Self-reported health: Poor | 0.52 | 0.34–0.78 | < 0.001 | 6.60 | 1.00–43.64 | 0.05 | 1.14 | 0.82–1.58 | 0.43 |
| Not proficient English | 0.59 | 0.22–1.59 | 0.30 | – | – | – | 0.49 | 0.21–1.16 | 0.10 |
| Distrust Doctor | 0.86 | 0.59–1.25 | 0.43 | 1.04 | 0.42–2.55 | 0.94 | 1.10 | 0.88–1.38 | 0.41 |
| Bad Communication with Doctor | 1.06 | 0.81–1.40 | 0.65 | 0.65 | 0.29–1.47 | 0.30 | 1.22 | 1.04–1.42 | 0.01 |
| MA plan penetration | 0.99 | 0.98–1.00 | 0.20 | 1.04 | 1.00–1.08 | 0.03 | 1.00 | 1.00–1.01 | 0.42 |
| Physician Number/100,000 population | 0.99 | 0.99–1.00 | < 0.001 | 1.00 | 0.99–1.02 | 0.75 | 1.01 | 0.98–1.04 | 0.62 |
| N | 3997 | 331 | 19,024 | ||||||