. 2018 Dec 3;179(1):16–25. doi: 10.1001/jamainternmed.2018.5086

Table 4. Association Between Physician Characteristics and Low-Value Services.

Physician Characteristic	Within-Region Analysis^a		Within-Organization Analysis^b
Physician Characteristic	Additional Services per 100 Beneficiaries per Year (95% CI)	P Value	Additional Services per 100 Beneficiaries per Year (95% CI)	P Value
Academic degree (MD vs DO)	−1.10 (−1.66 to −0.55)	<.001	−1.05 (−1.54 to 0.55)	<.001
Foreign medical graduate	1.80 (1.37 to 2.23)	<.001	0.71 (0.38 to 1.04)	<.001
Graduate of medical school in US News and World Report 2013 top 20 rank	−0.39 (−0.88 to 0.09)	.11	−0.41 (−0.83 to 0.01)	.05
Age^c	0.23 (0.10 to 0.36)	.001	0.16 (0.05 to 0.27)	.004
Female	0.82 (0.54 to 1.11)	<.001	1.13 (0.88 to 1.37)	<.001
Academic title (vs no professorship)
Full professor	−4.80 (−6.01 to −3.59)	<.001	−0.95 (−2.09 to 0.19)	.10
Associate professor	−4.14 (−5.38 to −2.90)	<.001	−0.86 (−2.00 to 0.27)	.14
Assistant professor	−3.03 (−3.66 to −2.41)	<.001	−0.38 (−0.99 to 0.24)	.23
Any publication authorship	−0.13 (−0.49 to 0.22)	.47	−0.16 (−0.44 to 0.120)	.25
No. of publications authored	0.01 (−0.01 to 0.03)	.45	0.01 (−0.01 to 0.02)	.24
Clinical trial investigator	−0.22 (−2.82 to 2.37)	.87	−0.08 (−1.90 to 1.73)	.93
NIH grant recipient	−0.49 (−2.94 to 1.96)	.69	−0.34 (−2.05 to 1.38)	.70
Any pharmaceutical and/or device company payments	1.86 (1.60 to 2.12)	<.001	0.43 (0.18 to 0.699)	.001
Pharmaceutical and/or device company payment amount^d	0.11 (0.03 to 0.19)	.01	0.09 (0.03 to 0.15)	.002
Medicare FFS panel size^e	10.59 (8.14 to 13.05)	<.001	2.53 (0.72 to 4.34)	.006

Abbreviations: DO, doctor of osteopathy; FFS, fee-for-service; MD, doctor of medicine; NIH, National Institutes of Health.

^{^a}

In addition to patient sociodemographic and clinical characteristics, this model contains indicators for each patient hospital referral region, effectively comparing physicians within the same geographic service area. Confidence intervals were estimated using robust variance estimators, clustered at the physician level.

^{^b}

In addition to patient sociodemographic characteristics, clinical characteristics, and hospital referral region, this model also contains indicators for provider organization tax identification number, effectively comparing physicians within the same provider organization. Confidence intervals were estimated using robust variance estimators, clustered at the physician level.

^{^c}

Coefficient is scaled to represent the additional services per 100 beneficiaries that are associated with a 10-year increase in age.

^{^d}

Coefficient is scaled to represent the additional services per 100 beneficiaries that are associated with a $5000 increase in pharmaceutical and/or device company payments.

^{^e}

Coefficient is scaled to represent the additional services per 100 beneficiaries that are associated with an increase of 100 patients per year.