TABLE 2.
Average marginal effects of receiving multidisciplinary cancer consultation (MDCc) among Medicare beneficiaries with surgically resected cancer from 2007 to 2015
| Unadjusted marginal effects | Adjusted marginal effects a | |||
|---|---|---|---|---|
| Percentage (%) points | (95% CI) | Percentage (%) points | (95% CI) | |
| Patient level | ||||
| Age | −1.24 | (−1.28, −1.20) | −0.96 | (−0.96, −0.86) |
| Race and ethnicity | ||||
| Non‐Hispanic White | Reference | Reference | ||
| Non‐Hispanic Black | −7.19 | (−8.44, −5.94) | −3.30 | (−4.78, −1.83) |
| Hispanics | 0.27 | (−1.17, 1.70) | 1.79 | (0.18, 3.40) |
| Other | −0.35 | (−1.71, 1.01) | 1.93 | (0.34, 3.52) |
| Sex | ||||
| Male | Reference | Reference | ||
| Female | 22.03 | (21.28, 22.79) | 0.13 | (−0.80, 1.07) |
| Marital status | ||||
| Single | Reference | Reference | ||
| Married | 7.23 | (6.07, 8.39) | 4.19 | (2.96, 5.42) |
| Other | 1.18 | (0.00, 2.36) | 1.13 | (−0.11, 2.37) |
| Medicaid coverage | ||||
| No | Reference | Reference | ||
| Yes | −13.12 | (−13.91, −12.32) | −7.16 | (−8.09, −6.22) |
| Cancer type | ||||
| Breast | Reference | Reference | ||
| Colorectal | −36.52 | (−37.15, −35.88) | −39.4 | (−40.37, −38.36) |
| Lung | −32.91 | (−33.86, −31.97) | −32.4 | (−34.25, −30.59) |
| Stage | ||||
| I | Reference | Reference | ||
| II | −0.25 | (−0.93, 0.44) | 6.58 | (5.85, 7.31) |
| III | −0.67 | (−1.51, 0.18) | 16.31 | (15.47, 17.15) |
| Comorbidities | ||||
| 0 | Reference | Reference | ||
| 1 | −7.40 | (−8.11, −6.69) | −2.05 | (−2.80, −1.31) |
| 2 | −1.32 | (−14.43, −11.97) | −4.11 | (−5.38, −2.83) |
| 3+ | −1.92 | (−20.13, −18.27) | −6.69 | (−7.71, −5.67) |
| Neighborhood level | ||||
| % Black composition | ||||
| Lower quartile | Reference | Reference | ||
| Second quartile | −1.20 | (−2.04, −0.36) | −0.19 | (−1.11, 0.73) |
| Third quartile | −2.77 | (−3.62, −1.93) | −0.19 | (−1.18, 0.81) |
| Highest quartile | −5.34 | (−6.20, −4.47) | −1.50 | (−2.73, −0.28) |
| % Hispanic composition | ||||
| Lower quartile | Reference | Reference | ||
| Second quartile | 1.40 | (0.55, 2.26) | 0.24 | (−0.72, 1.22) |
| Third quartile | 0.93 | (0.07, 1.78) | 0.35 | (−0.75, 1.44) |
| Highest quartile | −1.43 | (−2.29, −0.56) | −1.38 | (−2.71, −0.06) |
| Area deprivation index | ||||
| Lowest quintile (lowest disadvantage) | Reference | Reference | ||
| Second quintile | −2.37 | (−3.27, −1.46) | 0.65 | (−0.324, 1.62) |
| Third quintile | −3.98 | (−4.91, −3.04) | 0.41 | (−0.6, 1.46) |
| Fourth quintile | −5.54 | (−6.50, −4.58) | −0.05 | (−1.18, 1.08) |
| Highest quintile (most disadvantage) | −8.24 | (−9.25, −7.23) | −0.62 | (−1.86, 0.63) |
| Rurality (RUCC) | ||||
| Urban | Reference | Reference | ||
| Rural | −1.50 | (−2.32, −0.68) | −1.75 | (−3.00, −0.52) |
| SEER region | ||||
| Northeast | Reference | Reference | ||
| Midwest | 5.33 | (4.23, 6.43) | 8.13 | (5.41, 10.85) |
| Southwest | 11.22 | (9.62, 12.81) | 7.82 | (4.32, 11.32) |
| South | 4.53 | (3.63, 5.42) | 5.45 | (3.08, 7.83) |
| West | 7.05 | (6.23, 7.88) | 4.91 | (2.70, 7.12) |
| Surgeon level | ||||
| Surgeon specialty | ||||
| General | Reference | Reference | ||
| Oncology | 7.33 | (6.36, 8.31) | −0.55 | (−2.32, 1.23) |
| Other surgeon specialty | −21.80 | (−22.59, −21.01) | 0.71 | (−0.58, 1.99) |
| Surgeon graduation year | ||||
| Before 2000 | Reference | Reference | ||
| 2000 or later | 1.20 | (0.13, 2.27) | 0.79 | (−0.62, 2.21) |
| Surgeon sex | ||||
| Male | Reference | Reference | ||
| Female | 17.02 | (16.33, 17.71) | 0.49 | (−0.72, 1.70) |
| Hospital level | ||||
| Hospital type | ||||
| Non‐profit | Reference | Reference | ||
| Private | 1.16 | (0.09, 2.22) | −1.29 | (−3.17, 0.59) |
| Government | −0.74 | (−1.68, 0.20) | −1.66 | (−3.59, 0.26) |
| NCI designation | ||||
| No | Reference | Reference | ||
| Yes | −1.69 | (−2.98, −0.39) | −2.80 | (−6.20, 0.60) |
| CoC accreditation | ||||
| No | Reference | Reference | ||
| Yes | 2.09 | (1.45, 2.73) | 2.90 | (1.41, 4.40) |
| Teaching status | ||||
| No | Reference | Reference | ||
| Yes | −1.64 | (2.28, −0.99) | −0.44 | (−1.84, 0.95) |
| Disproportionate share payment qualification | ||||
| No | Reference | Reference | ||
| Yes | 0.24 | (−0.57, 1.05) | −2.06 | (−3.55, −0.58) |
| Rural primary status | ||||
| No | Reference | Reference | ||
| Yes | −18.38 | (−20.71, −16.06) | −17.57 | (−21.45, −13.70) |
Abbreviations: CI, Confidence Interval; CoC, Commission on Cancer; NCI, National Cancer Institute; RUCC, Rural–Urban Continuum Codes (2013); SEER, Surveillance, Epidemiology, and End Results Program.
Adjusted for age, race and ethnicity, sex, marital status, cancer type, cancer stage, comorbidities, percent Black and Hispanic neighborhood composition, area deprivation index, rurality, SEER region surgeon specialty, graduation year, sex, hospital type, NCI designation, Commission on Cancer accreditation, teaching status, disproportionate share payment qualification, rural primary status designation, year of diagnosis, and surgeon and hospital random effects.