Table 2.
Parameter estimates from the five multilevel regression models examining the associations of LOD with individual-level and state-level variables
| Parameter | Length of disability | ||||
|---|---|---|---|---|---|
| Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |
| Intercept | 3.835*** | 3.880*** | 3.268*** | 3.269*** | 3.346*** |
| Gender | |||||
| Female | 0.078*** | 0.075*** | 0.040* | ||
| Malea | |||||
| Age (years) | 0.005*** | 0.005*** | 0.005*** | ||
| Tenure (years) | −0.004*** | −0.004*** | −0.004*** | ||
| AWW/$100 | 0.017*** | 0.013*** | 0.013** | ||
| Industry type | |||||
| Mining | 0.452*** | 0.445*** | 0.443*** | ||
| Construction | 0.193*** | 0.183*** | 0.182*** | ||
| Transportation | 0.258*** | 0.247*** | 0.247*** | ||
| Agriculture | 0.090 | 0.083 | 0.081 | ||
| Manufacturing | 0.126** | 0.118** | 0.117** | ||
| Wholesale trade | 0.084 | 0.076 | 0.076 | ||
| Retail trade | 0.127** | 0.119** | 0.118** | ||
| Services | 0.101* | 0.092* | 0.091* | ||
| Public administration | 0.077 | 0.069 | 0.068 | ||
| Financea | |||||
| Injury severity | |||||
| More severe | 0.086*** | 0.085*** | 0.085*** | ||
| Less severea | |||||
| Early opioid/100 mg MEA | 0.014*** | 0.014*** | 0.014*** | ||
| eMRI scan | |||||
| Yes | 0.426*** | 0.435*** | 0.402*** | ||
| Noa | |||||
| Lumbar spine surgery | |||||
| Yes | 0.719*** | 0.715*** | 0.712*** | ||
| Noa | |||||
| Litigation status | |||||
| Yes | 1.144*** | 1.152*** | 1.152*** | ||
| Noa | |||||
| Median household income ($) | −0.007*** | −0.007*** | − 0.007*** | ||
| State physician density | −0.001*** | −0.001* | − 0.001** | - < 0.001 | |
| State Orthopedic surgeons density | −0.027 | 0.070 | 0.070 | 0.042* | |
| MRI facility rate | −0.078 | −0.144*** | − 0.129*** | −0.182*** | |
| Wage replacement rate | 0.002 | 0.004 | 0.004 | 0.004 | |
| Waiting period | 0.052*** | 0.069*** | 0.069*** | 0.069*** | |
| Retroactive period | 0.006** | 0.006*** | 0.006*** | 0.006*** | |
| Treating provider change | |||||
| Allowed | 0.234*** | 0.115*** | 0.109*** | 0.114*** | |
| Allowed once | 0.001 | −0.118** | − 0.116*** | − 0.114*** | |
| Not alloweda | |||||
| Treating provider choice | |||||
| Allowed | 0.165*** | 0.270*** | 0.261*** | 0.332*** | |
| Not-alloweda | |||||
| State medical fee schedule | |||||
| Yes | 0.057* | 0.100*** | 0.100*** | 0.098*** | |
| Noa | |||||
| Unemployment rate | 0.024** | 0.013* | 0.012* | 0.011 | |
|
MRI (yes) X State Orthopedic surgeons density MRI (yes) X State Orthopedic surgeons density |
0.053*** | ||||
|
MRI (yes) X Dr choice (yes) MRI (yes) X Dr choice (no) |
0.099** | ||||
|
MRI (Yes) X male gender MRI (Yes) X female gender |
−0.047** | ||||
|
MRI (yes) X MRI facility density MRI (no) X MRI facility density |
−0.058** | ||||
| Variance components | |||||
| Within-state variability | 1.393*** | 1.390*** | 0.914*** | 0.910*** | 0.910*** |
| Between-state variability | 0.072*** | 0.035*** | 0.026*** | 0.025*** | 0.025*** |
| ICC | 5% | 2% | 3% | 3% | 3% |
| Proportional reduction in between-state variability | 51% | 64% | 65% | 65% | |
| Random slope | |||||
| eMRI | 0.011** | 0.011** | |||
| Model fit statistic | |||||
| -2LL | 188,306 | 188,221*** | 163,485*** | 163,323*** | 163,320* |
| BIC | 188,310 | 188,229*** | 163,493*** | 163,342*** | 163,339* |
AWW Average weekly wage, MEA Morphine equivalent amount, eMRI Early magnetic resonance imaging, ICC Intraclass correlation coefficient, −2LL −2 log likelihood ratio, BIC Bayesian information criterion
*Indicator of statistical significance p<. 05; **p<. 01; ***p<. 001
aIndicator of reference group