Table 3.
Factors predicting: 1) surgery at HVH and 2) surgery from HVS; stratified by colonoscopy facility type.
| Demographic characteristics | Surgery at HVHab | Surgery by HVS/CRSab | |||
|---|---|---|---|---|---|
| Received colonoscopy at a hospital | Model 1 (n=1,059) | Model 2 (n=1,015) | |||
| OR | CI | OR | CI | ||
| Age (years) | 0.99 | (0.97–1.01) | 0.99 | (0.97–1.01) | |
| Year of diagnosis | 0.99 | (0.89–1.09) | 1.06 | (0.96–1.17) | |
| % 4 year college | Low | Ref. | Ref. | ||
| Medium | 1.26 | (0.77–2.08) | 1.55 | (0.95–2.53) | |
| High | 1.62 | (0.96–2.71) | 1.83 | (1.11–3.01)* | |
| State buy-in | Yes | Ref. | Ref. | ||
| No | 1.29 | (0.84–1.97) | 1.44 | (0.96–2.15) | |
| Stage | II | Ref. | Ref. | ||
| III | 1.20 | (0.89–1.62) | 0.92 | (0.70–1.23) | |
| Charlson score | 0 | 1.82 | (1.18–2.80)* | 0.91 | (0.60–1.39) |
| 1 | 1.50 | (0.95–2.39) | 0.75 | (0.47–1.18) | |
| 2+ | Ref. | Ref. | |||
| Colonoscopist specialty | GE | Ref. | Ref. | ||
| CRS | 3.75 | (2.18–6.45)* | 7.89 | (4.41–14.1)* | |
| GS | 0.79 | (0.51–1.24) | 0.34 | (0.22–0.54)* | |
| PCP/Other | 1.19 | (0.65–2.16) | 0.77 | (0.42–1.41) | |
| Drive time to nearest | 0–15 | 7.50 | (4.37–12.9)* | 1.22 | (0.75–2.00) |
| HVH (minutes) | >15–30 | 3.11 | (1.83–2.80)* | 1.21 | (0.73–2.01) |
| >30–45 | 1.69 | (0.99–2.89) | 1.00 | (0.59–1.70) | |
| 45+ | Ref. | Ref. | |||
| Colonoscopy and surgery at same hospital X Rural status | Same hospital/urban | Ref. | Ref. | ||
| Same hospital/rural | 0.65 | (0.35–1.20) | 0.51 | (0.28–0.92)* | |
| Different hospital/urban | 2.54 | (1.70–3.78)* | 1.93 | (1.35–2.76)* | |
| Different hospital/rural | 6.25 | (3.36–11.62)* | 4.96 | (2.71–9.10)* | |
| Received colonoscopy at an Ambulatory Surgical Center | Model 3 (n=518) | Model 4 (n=496) | |||
| OR | CI | OR | CI | ||
| Age (years) | 1.00 | (0.96–1.03) | 1.00 | (0.96–1.03) | |
| Year of diagnosis | 1.23 | (1.05–1.44)* | 1.17 | (1.00–1.36)* | |
| % 4 year college | Low | Ref. | Ref. | ||
| Medium | 1.00 | (0.38–2.85) | 1.37 | (0.51–3.66) | |
| High | 2.04 | (0.74–5.58) | 1.77 | (0.64–4.84) | |
| State buy-in | Yes | Ref. | Ref. | ||
| No | 2.72 | (1.26–5.87)* | 1.82 | (0.87–3.78) | |
| Stage | II | Ref. | Ref. | ||
| III | 1.57 | (0.99–2.48) | 1.59 | (1.03–2.48)* | |
| Charlson score | 0 | Ref. | Ref. | ||
| 1 | 1.81 | (0.92–3.60) | 0.86 | (0.43–1.74) | |
| 2+ | 1.87 | (0.89–3.91) | 0.77 | (0.37–1.62) | |
| Colonoscopist specialty | GE | Ref. | Ref. | ||
| CRS | 3.15 | (1.30–7.58)* | 5.06 | (2.01–12.7)* | |
| GS | 0.53 | (0.17–1.60) | 0.31 | (0.10–0.94)* | |
| PCP/Other | 0.68 | (0.20–2.35) | 1.14 | (0.33–3.91) | |
| Rural status | Urban | Ref. | Ref. | ||
| Rural | 1.57 | (0.70–3.49) | 1.69 | (0.76–3.73) | |
| Drive time to nearest | 0–15 | 5.53 | (2.59–11.8)* | 1.96 | (0.95–4.02) |
| HVH (minutes) | >15–30 | 2.78 | (1.31–5.91)* | 1.48 | (0.72–3.07) |
| >30–45 | 1.51 | (0.67–3.41) | 1.40 | (0.63–3.13) | |
| 45+ | Ref. | Ref. | |||
a
In addition to all variables in the table, all models were also adjusted for gender, race, marital status, function related indicators and census tract percentage below poverty indicator
b
Models did not include patients with missing independent variable information
GE=Gastroenterologist; CRS=Colorectal surgeon; GS=General surgeon; PCP=Primary care provider; HVH=High rectal cancer resection volume hospital; HVS=High rectal cancer resection volume surgeon
*
Significant at α=0.05