Table 1. Patient, Area-Level, and Visit Characteristics Associated With Routine Testing Among Healthy, Asymptomatic Medicare Beneficiaries.
| Characteristic | No. (%) | Any test, adjusted OR (95%CI) | ||||
|---|---|---|---|---|---|---|
| ECG (n = 5421) | Urinalysis (n = 7515) | Thyrotropin (n = 6534) | Any test (n = 14 017) | No test (n = 61 258) | ||
| Age, y | ||||||
| 66-74 | 3892 (71.8) | 5483 (73.0) | 4735 (72.5) | 10 159 (72.5) | 42 148 (68.8) | 1.69 (1.53-1.86) |
| 75-84 | 1327 (24.5) | 1776 (23.6) | 1565 (24.0) | 3340 (23.8) | 15 449 (25.2) | 1.53 (1.38-1.70) |
| ≥85 | 202 (3.7) | 256 (3.4) | 234 (3.6) | 518 (3.7) | 3661 (6.0) | 1 [Reference] |
| Female sex | 3403 (62.8) | 4690 (62.4) | 4468 (68.4) | 9027 (64.4) | 39 080 (63.8) | 1.05 (1.01-1.09) |
| Race | ||||||
| White | 4918 (90.7) | 6836 (91.0) | 5969 (91.4) | 12 795 (91.3) | 56 061 (91.5) | 1.32 (1.16-1.49) |
| Black | 139 (2.6) | 206 (2.7) | 156 (2.4) | 347 (2.5) | 1525 (2.5) | 1 [Reference] |
| Hispanic | 126 (2.3) | 154 (2.1) | 136 (2.1) | 293 (2.1) | 1264 (2.1) | 1.16 (0.97-1.40) |
| Other | 238 (4.4) | 319 (4.2) | 273 (4.2) | 582 (4.2) | 2408 (3.9) | 1.30 (1.11-1.51) |
| Medicaid enrollment | 102 (1.9) | 129 (1.7) | 123 (1.9) | 259 (1.9) | 1507 (2.5) | 0.80 (0.69-0.92) |
| Disability | 167 (3.1) | 202 (2.7) | 177 (2.7) | 413 (3.0) | 2275 (3.7) | 0.83 (0.74-0.93) |
| US Census region | ||||||
| Northeast | 2022 (37.3) | 1434 (19.1) | 1091 (16.7) | 3191 (22.8) | 12 768 (20.8) | 1.28 (1.00-1.62) |
| Midwest | 878 (16.2) | 1467 (19.5) | 1054 (16.1) | 2633 (18.8) | 15 610 (25.5) | 1 [Reference] |
| South | 1911 (35.3) | 3394 (45.2) | 3101 (47.5) | 5810 (41.5) | 18 723 (30.6) | 1.61 (1.35-1.92) |
| West | 610 (11.3) | 1220 (16.2) | 1288 (19.7) | 2383 (17.0) | 14 157 (23.1) | 0.91 (0.73-1.13) |
| Setting of residence | ||||||
| Metropolitan | 4915 (90.7) | 6536 (87.0) | 5733 (87.7) | 12 187 (86.9) | 47 793 (78.0) | 1.29 (1.15-1.46) |
| Micropolitan | 302 (5.6) | 521 (6.9) | 434 (6.6) | 1001 (7.1) | 7213 (11.8) | 0.86 (0.75-0.98) |
| Suburban | 107 (2.0) | 254 (3.4) | 196 (3.0) | 445 (3.2) | 3363 (5.5) | 0.86 (0.73-1.00) |
| Rural | 97 (1.8) | 204 (2.7) | 171 (2.6) | 384 (2.7) | 2889 (4.7) | 1 [Reference] |
| Area-level income, % of the federal poverty level | ||||||
| 0-200 | 973 (18.0) | 1933 (25.7) | 1751 (26.8) | 3490 (24.9) | 18 818 (30.7) | 1 [Reference] |
| 201-300 | 1860 (34.3) | 2812 (37.4) | 2437 (37.3) | 5246 (37.4) | 25 067 (40.9) | 1.05 (1.00-1.11) |
| 301-400 | 1457 (26.9) | 1730 (23.0) | 1462 (22.4) | 3277 (23.4) | 11 949 (19.5) | 1.15 (1.08-1.23) |
| >400 | 1131 (20.9) | 1040 (13.8) | 884 (13.5) | 2004 (14.3) | 5424 (8.9) | 1.26 (1.16-1.37) |
| Clinician specialty | ||||||
| Primary care | 5077 (93.7) | 6854 (91.2) | 6138 (93.9) | 12 893 (92.0) | 53 889 (88.0) | 1.59 (1.48-1.70) |
| Other | 344 (6.4) | 661 (8.8) | 396 (6.1) | 1124 (8.0) | 7369 (12.0) | 1 [Reference] |
| Accountable Care Organization (patient level) | ||||||
| Yes | 1515 (28.0) | 2094 (27.9) | 1914 (29.3) | 3846 (27.4) | 14 939 (24.4) | 1.05 (1.00-1.10) |
| No | 3906 (72.1) | 5421 (72.1) | 4620 (70.7) | 10 171 (72.6) | 46 319 (75.6) | 1 [Reference] |
| Elixhauser counts, mean (SD) | 0.11 (0.35) | 0.09 (0.33) | 0.09 (0.32) | 0.10 (0.34) | 0.10 (0.34) | 0.99 (0.93-1.04) |
Abbreviations: ECG, electrocardiogram; OR, odds ratio.