ORs Estimated from a Multivariable Mixed Logistic Regression Model of Patient and Diagnosing Facility Characteristics as Predictors of Surgery for LDH in Purchased Care versus Direct Care within 1 Year Postdiagnosis
| Characteristic . | OR (95% CI) . | P . |
|---|---|---|
| Age in years (scaled) | 1.09 (1.01-1.18) | 0.03 |
| Male sex | 1.05 (0.86-1.28) | 0.63 |
| Tobacco use | 1.06 (0.94-1.20) | 0.33 |
| Presence of comorbidities | 1.20 (1.06-1.36) | <0.01 |
| Beneficiary status | ||
| Retired | Reference | — |
| Active duty | 0.75 (0.59-0.95) | 0.02 |
| Others/dependents | 1.00 (0.75-1.34) | 0.99 |
| Facility type | ||
| Clinic | Reference | — |
| Hospital—no specialty | 1.50 (1.28-1.76) | <0.01 |
| Hospital—specialty | 0.12 (0.10-0.15) | <0.01 |
| Facility branch | ||
| Army | Reference | — |
| Navy | 0.24 (0.21-0.28) | <0.01 |
| Air Force | 1.01 (0.86-1.19) | 0.89 |
| DHA/Joint Facility | 0.96 (0.79-1.17) | 0.71 |
| MEPRS service code | ||
| Primary care | Reference | — |
| Surgical care | 0.33 (0.27-0.40) | <0.01 |
| Orthopedic care | 0.39 (0.33-0.46) | <0.01 |
| Emergency medicine | 0.72 (0.51-1.03) | 0.07 |
| Rehabilitation care | 0.92 (0.70-1.23) | 0.58 |
| Characteristic . | OR (95% CI) . | P . |
|---|---|---|
| Age in years (scaled) | 1.09 (1.01-1.18) | 0.03 |
| Male sex | 1.05 (0.86-1.28) | 0.63 |
| Tobacco use | 1.06 (0.94-1.20) | 0.33 |
| Presence of comorbidities | 1.20 (1.06-1.36) | <0.01 |
| Beneficiary status | ||
| Retired | Reference | — |
| Active duty | 0.75 (0.59-0.95) | 0.02 |
| Others/dependents | 1.00 (0.75-1.34) | 0.99 |
| Facility type | ||
| Clinic | Reference | — |
| Hospital—no specialty | 1.50 (1.28-1.76) | <0.01 |
| Hospital—specialty | 0.12 (0.10-0.15) | <0.01 |
| Facility branch | ||
| Army | Reference | — |
| Navy | 0.24 (0.21-0.28) | <0.01 |
| Air Force | 1.01 (0.86-1.19) | 0.89 |
| DHA/Joint Facility | 0.96 (0.79-1.17) | 0.71 |
| MEPRS service code | ||
| Primary care | Reference | — |
| Surgical care | 0.33 (0.27-0.40) | <0.01 |
| Orthopedic care | 0.39 (0.33-0.46) | <0.01 |
| Emergency medicine | 0.72 (0.51-1.03) | 0.07 |
| Rehabilitation care | 0.92 (0.70-1.23) | 0.58 |
Reference group for outcome: surgery in direct care. Specialty hospitals are defined by presence of spine training or residency programs or neurosurgery billets. Presence of comorbidities is defined as record of at least one selected risk factor/health condition in MDR health risk file in the year of last available follow-up for the patient. Selected risk factors/health conditions included cancer, cardiovascular disease, cerebrovascular disease, diabetes, osteoarthritis, and rheumatoid arthritis/inflammatory, renal, and respiratory disease.
ORs Estimated from a Multivariable Mixed Logistic Regression Model of Patient and Diagnosing Facility Characteristics as Predictors of Surgery for LDH in Purchased Care versus Direct Care within 1 Year Postdiagnosis
| Characteristic . | OR (95% CI) . | P . |
|---|---|---|
| Age in years (scaled) | 1.09 (1.01-1.18) | 0.03 |
| Male sex | 1.05 (0.86-1.28) | 0.63 |
| Tobacco use | 1.06 (0.94-1.20) | 0.33 |
| Presence of comorbidities | 1.20 (1.06-1.36) | <0.01 |
| Beneficiary status | ||
| Retired | Reference | — |
| Active duty | 0.75 (0.59-0.95) | 0.02 |
| Others/dependents | 1.00 (0.75-1.34) | 0.99 |
| Facility type | ||
| Clinic | Reference | — |
| Hospital—no specialty | 1.50 (1.28-1.76) | <0.01 |
| Hospital—specialty | 0.12 (0.10-0.15) | <0.01 |
| Facility branch | ||
| Army | Reference | — |
| Navy | 0.24 (0.21-0.28) | <0.01 |
| Air Force | 1.01 (0.86-1.19) | 0.89 |
| DHA/Joint Facility | 0.96 (0.79-1.17) | 0.71 |
| MEPRS service code | ||
| Primary care | Reference | — |
| Surgical care | 0.33 (0.27-0.40) | <0.01 |
| Orthopedic care | 0.39 (0.33-0.46) | <0.01 |
| Emergency medicine | 0.72 (0.51-1.03) | 0.07 |
| Rehabilitation care | 0.92 (0.70-1.23) | 0.58 |
| Characteristic . | OR (95% CI) . | P . |
|---|---|---|
| Age in years (scaled) | 1.09 (1.01-1.18) | 0.03 |
| Male sex | 1.05 (0.86-1.28) | 0.63 |
| Tobacco use | 1.06 (0.94-1.20) | 0.33 |
| Presence of comorbidities | 1.20 (1.06-1.36) | <0.01 |
| Beneficiary status | ||
| Retired | Reference | — |
| Active duty | 0.75 (0.59-0.95) | 0.02 |
| Others/dependents | 1.00 (0.75-1.34) | 0.99 |
| Facility type | ||
| Clinic | Reference | — |
| Hospital—no specialty | 1.50 (1.28-1.76) | <0.01 |
| Hospital—specialty | 0.12 (0.10-0.15) | <0.01 |
| Facility branch | ||
| Army | Reference | — |
| Navy | 0.24 (0.21-0.28) | <0.01 |
| Air Force | 1.01 (0.86-1.19) | 0.89 |
| DHA/Joint Facility | 0.96 (0.79-1.17) | 0.71 |
| MEPRS service code | ||
| Primary care | Reference | — |
| Surgical care | 0.33 (0.27-0.40) | <0.01 |
| Orthopedic care | 0.39 (0.33-0.46) | <0.01 |
| Emergency medicine | 0.72 (0.51-1.03) | 0.07 |
| Rehabilitation care | 0.92 (0.70-1.23) | 0.58 |
Reference group for outcome: surgery in direct care. Specialty hospitals are defined by presence of spine training or residency programs or neurosurgery billets. Presence of comorbidities is defined as record of at least one selected risk factor/health condition in MDR health risk file in the year of last available follow-up for the patient. Selected risk factors/health conditions included cancer, cardiovascular disease, cerebrovascular disease, diabetes, osteoarthritis, and rheumatoid arthritis/inflammatory, renal, and respiratory disease.
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