Table 3.
Patient characteristics and provider specialty in relation to receipt of co-testing versus Pap alone in three US health care systems (2010–2017).
| MGB | KPWA | PHHS-UTSW | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Count (%) | OR * (95% CI) | p-value | Count (%) | OR * (95% CI) | p-value | Count (%) | OR * (95% CI) | p-value | |
| Age | - | 0.99 (0.99,0.99) | <0.001 | - | 1.00 (1.00,1.00) | 0.73 | - | 1.00 (1.00,1.00) | 0.94 |
| Race | |||||||||
| White | 34,117 (52.1%) | (ref) | - | 16,989 (23.6%) | (ref) | - | 1,215 (19.2%) | (ref) | - |
| Asian | 3,927 (57.5%) | 0.99 (0.93,1.06) | 0.82 | 4,126 (26.3%) | 0.92 (0.85,1.00) | 0.06 | 404 (14.7%) | 1.09 (0.91,1.32) | 0.35 |
| Black | 4,561 (50.3%) | 0.94 (0.89,1.00) | 0.05 | 1,363 (25.1%) | 0.94 (0.82,1.06) | 0.32 | 4,367 (23%) | 0.99 (0.88,1.11) | 0.86 |
| Hispanic | 8,030 (65.5%) | 1.37 (1.28,1.45) | <0.001 | 1,824 (26.1%) | 1 (0.90,1.12) | 0.97 | 7,831 (12.7%) | 0.93 (0.84,1.04) | 0.19 |
| Other | 2,032 (53.5%) | 0.89 (0.81,0.97) | 0.01 | 2,212 (23.8%) | 1.04 (0.94,1.16) | 0.42 | 74 (14.5%) | 0.83 (0.58,1.20) | 0.33 |
| Insurance | |||||||||
| Commercial | 37,340 (53%) | (ref) | - | 24,954 (24.5%) | (ref) | - | 727 (16.1%) | 1.23 (1.06,1.42) | 0.01 |
| Medicare/Medicaid/Other Government | 14,931 (57.3%) | 1.12 (1.07,1.16) | <0.001 | 1,560 (21%) | 0.61 (0.54,0.68) | <0.001 | 3,227 (7.2%) | (ref) | - |
| Multiple/Other/Unknown | 125 (63.1%) | 1.23 (0.86,1.76) | 0.25 | 0 (0%) | - | - | 59 (5.4%) | 1.18 (0.80,1.73) | 0.40 |
| Uninsured/Medical Assistance | 271 (33%) | 0.71 (0.59,0.86) | <0.001 | 0 (0%) | - | - | 9,878 (25.1%) | 1.01 (0.94,1.08) | 0.84 |
| Risk Group | |||||||||
| Average Risk | 35,608 (51.1%) | (ref) | - | 11,583 (21.1%) | (ref) | - | 5,227 (11.8%) | (ref) | - |
| Unknown Risk ** | 17,059 (61.3%) | 1.13 (1.09,1.18) | <0.001 | 14,931 (27.5%) | 1.04 (0.99,1.10) | 0.1510 | 8,664 (18.9%) | 1.25 (1.17,1.32) | <0.001 |
| Specialty | |||||||||
| Family Medicine | 1,000 (62.9%) | (ref) | - | 19,873 (23.5%) | (ref) | - | 4,721 (31.2%) | (ref) | - |
| Internal Medicine | 27,550 (58.1%) | 2.07 (1.19,3.59) | 0.01 | 1,546 (29.4%) | 0.92 (0.44,1.91) | 0.82 | 4,763 (36.5%) | 0.78 (0.37,1.64) | 0.51 |
| OB/GYN | 14,380 (57.1%) | 1.37 (0.74,2.52) | 0.32 | 4,984 (27.5%) | 5.44 (3.46,8.53) | <0.001 | 2,480 (4.6%) | 0.16 (0.09,0.29) | <0.001 |
| Other | 4,575 (70.8%) | 2.09 (1.15,3.80) | 0.02 | 111 (8.6%) | 0.65 (0.20,2.11) | 0.47 | 1,806 (24.9%) | 0.25 (0.12,0.52) | <0.001 |
| Unknown | 5,162 (30.7%) | 1.23 (0.59,2.58) | 0.58 | 0 (0%) | - | - | 121 (13.9%) | 0.48 (0.15,1.52) | 0.21 |
Notes:
Estimates based on mixed-effects multilevel logistic models fit to data specific to each healthcare system with main effects for calendar year and age at screening, individual race/ethnicity, insurance type, and provider specialty and random intercepts for provider and facility.
Women whose electronic medical record data did not include any documentation of prior screening history were categorized as unknown risk.
Abbreviations:
MGB: Mass General Brigham
KPWA: Kaiser Permanente Washington
PHHS-UTSW: Parkland Health & Hospital System-University of Texas, Southwestern
Count: Number of patients receiving co-testing
OR: Odds Ratio
95% CI: 95% confidence interval