TABLE 3.
Medical oncologist‐level model of the association between 2010 and 2011 adoption of oncotype DX with geographic and patient‐sharing connections to early adopters a
| N = 3765 |
Crude OR (95% CI) |
p |
Adjusted b OR (95% CI) |
p | |
|---|---|---|---|---|---|
| Gender (Ref: Male) | Female | 1.11 (0.94,1.31) | 0.20 | 1.11 (0.93,1.33) | 0.24 |
| Patient Volume (Ref: 1–4) | 5–9 | 4.00 (3.24,4.93) | <0.001 | 4.19 (3.35,5.25) | <0.001 |
| 10–19 | 7.49 (6.07,9.24) | <0.001 | 8.09 (6.30,10.40) | <0.001 | |
| 20+ | 5.40 (4.27,6.82) | <0.001 | 6.50 (4.61,9.17) | <0.001 | |
| Number of Patient‐Sharing Ties to Medical Oncologists | 1.04 (1.04,1.05) | <0.001 | 0.96 (0.95,0.98) | <0.001 | |
| Number of Patient‐Sharing Ties to Surgeons | 1.15 (1.11,1.18) | <0.001 | 1.08 (1.04,1.13) | <0.001 | |
| Connection to Early Adopter Medical Oncologist (Ref: None) | Co‐Location | 2.37 (1.92,2.93) | <0.001 | 1.38 (1.04,1.83) | 0.03 |
| Patient‐Sharing | 1.66 (1.03,2.67) | 0.03 | 0.98 (0.58,1.67) | 0.95 | |
| Both | 2.97 (2.39,3.68) | <0.001 | 1.19 (0.88,1.63) | 0.25 | |
| Connection to Early Adopter Surgeon (Ref: None) | Co‐Location | 2.02 (1.72,2.39) | <0.001 | 1.25 (1.00,1.58) | 0.05 |
| Patient‐Sharing | 2.27 (1.23,4.22) | <0.001 | 1.85 (0.93,3.67) | 0.07 | |
| Both | 2.31 (1.85,2.89) | <0.001 | 1.13 (0.85,1.52) | 0.39 |
Abbreviations: CI, confidence interval; HRR, hospital referral region; OR, odds ratio; RUCA, rural‐urban commuting area.
a
Mixed‐effects logistic regression of adoption by the end of 2011, Random effect for HRR.
b
Also adjusted for census region, RUCA designation, area poverty, as well as HRR Medicare Advantage participation, minority population size, and per capita physicians and medical oncologists.