Article Figures & Data
Tables
- Table 1.
Baseline Characteristics of the Study Sample by Gender of the Usual Source of Care (USOC) (N = 21,365)
Characteristics Gender of the USOC Male (n = 16,896) Female (n = 4469) Percent of total sample 79.1 20.9 Patient characteristics Age, yr 51.7 (0.2) 48.8 (0.4) Female 50.0 (0.4) 70.8 (0.7) Race/ethnicity Hispanic (any race) 8.1 (0.4) 8.1 (0.5) Non-Hispanic White 77.4 (0.7) 73.6 (0.9) Black 9.0 (0.4) 11.3 (0.6) Other 5.5 (0.3) 7.1 (0.6) Education level <High school 5.4 (0.2) 4.3 (0.3) Some high school 9.7 (0.3) 8.9 (0.6) High school graduate 32.8 (0.5) 30.2 (0.9) Some college 23.6 (0.4) 22.7 (0.8) College graduate 28.4 (0.6) 34.0 (1.1) Household income level (% FPL) <100 7.8 (0.3) 7.8 (0.5) 100–124 3.4 (0.2) 3.5 (0.3) 125–199 12.0 (0.4) 11.3 (0.6) 200–399 30.0 (0.5) 30.4 (0.9) ≥400 46.8 (0.7) 47.0 (1.1) Census region Northeast 24.5 (1.0) 25.8 (1.4) Midwest 22.0 (1.0) 21.1 (1.3) South 37.0 (1.1) 34.6 (1.4) West 16.5 (1.0) 18.5 (1.5) Urbanicity (residence in MSA) 82.8 (1.0) 88.5 (1.0) Health insurance Private 78.2 (0.5) 79.9 (0.8) Public 15.9 (0.4) 14.8 (0.7) None 5.9 (0.2) 5.2 (0.4) Health status (SF-12) Physical Component Summary score 48.1 (0.13) 49.0 (0.23) Mental Component Summary score 51.2 (0.10) 50.5 (0.19) Self-rated health Excellent 22.8 (0.4) 23.6 (0.8) Very good 33.9 (0.5) 34.1 (0.9) Good 27.9 (0.4) 28.3 (0.9) Fair 11.3 (0.3) 10.5 (0.5) Poor 4.1 (0.2) 3.5 (0.3) Chronic health conditions* 1.09 (0.01) 1.00 (0.02) Body mass index (kg/m2) <20 4.9 (0.2) 6.0 (0.4) 20–<25 29.9 (0.4) 32.7 (0.9) 25–<30 36.6 (0.4) 32.7 (0.8) ≥30 28.5 (0.4) 28.7 (0.9) Smoker 18.3 (0.4) 16.3 (0.7) Skepticism toward medical care 1.93 (0.01) 1.91 (0.02) Survey panel year 2002 14.3 (0.5) 11.8 (0.7) 2003 15.7 (0.5) 12.8 (0.7) 2004 14.3 (0.4) 14.6 (0.8) 2005 14.4 (0.5) 13.1 (0.7) 2006 13.4 (0.4) 15.4 (0.8) 2007 10.5 (0.5) 10.9 (0.9) 2008 17.3 (0.7) 21.4 (1.2) USOC characteristics Specialty Family medicine/general practice 73.4 (0.7) 71.9 (1.2) General internal medicine 22.6 (0.6) 25.3 (1.1) Subspecialty 4.0 (0.2) 2.8 (0.3) Non-Hispanic white 82.5 (0.6) 74.6 (0.9) Values are provided as mean percentage (standard error). Percentages are population-weighted.
↵* From a count of 8 conditions: diabetes, hypertension, coronary heart disease, myocardial infarction, cerebrovascular disease, asthma, emphysema, and arthritis.
FPL, Federal Poverty Level; MSA, metropolitan statistical area, SF-12, 12-item Short Form.
- Table 2.
Adjusted Associations of Patient and Usual Source of Care (USOC) Characteristics with Female USOC (N = 21,365)
AOR (95% CI) P Patient characteristics Age, per 10 years 0.90 (0.87–0.93) <.001 Female 2.48 (2.28–2.70) <.001 Race/ethnicity Non-Hispanic white Reference Hispanic (any race) 0.93 (0.80–1.09) .36 Non-Hispanic black 1.07 (0.92–1.24) .40 Non-Hispanic other 0.99 (0.80–1.23) .96 Education level <High school Reference Some high school 1.08 (0.86–1.35) .52 High school graduate 1.03 (0.85–1.25) .78 Some college 1.01 (0.82–1.25) .91 College graduate 1.29 (1.05–1.60) .02 Household income level, % FPL <100 Reference 100–124 1.04 (0.81–1.33) .76 125–199 0.99 (0.82–1.21) .95 200–399 1.04 (0.87–1.24) .69 ≥400 1.01 (0.84–1.21) .93 Census region Northeast Reference Midwest 0.95 (0.80–1.13) .58 South 0.93 (0.81–1.07) .29 West 1.10 (0.92–1.30) .29 Urbanicity (residence in MSA) 1.43 (1.23–1.66) <.001 Health insurance Private Reference Public 0.97 (0.85–1.11) .69 None 0.88 (0.73–1.08) .22 Health status (SF-12) Physical Component Summary score 1.00 (1.00–1.01) .18 Mental Component Summary score 1.00 (0.99–1.00) .28 Self-rated health Excellent Reference Very good 0.97 (0.87–1.09) .66 Good 1.04 (0.91–1.18) .60 Fair 1.03 (0.85–1.25) .77 Poor 1.01 (0.76–1.33) .96 Chronic health conditions* 1.02 (0.97–1.06) .44 Body mass index (kg/m2) <20 Reference 20–<25 1.01 (0.84–1.23) .88 25–<30 1.02 (0.83–1.24) .87 ≥30 1.06 (0.86–1.30) .58 Smoker 0.93 (0.82–1.04) .20 Skepticism toward medical care 1.01 (0.96–1.07) .65 Survey panel year 1.07 (1.04–1.10) <.001 USOC characteristics Specialty Family medicine/general practice Reference General internal medicine 1.12 (0.98–1.28) .10 Subspecialty 0.78 (0.61–1.01) .06 Non-Hispanic white 0.65 (0.58–0.74) <.001 ↵* From a count of 8 conditions: diabetes, hypertension, coronary heart disease, myocardial infarction, cerebrovascular disease, asthma, emphysema, and arthritis.
AOR, adjusted odds ratio; CI, confidence interval; FPL, Federal Poverty Level; MSA, metropolitan statistical area; SF-12, 12-item Short Form.
- Table 3.
Patient Healthcare Utilization in Year 2 by Gender of Usual Source of Care (USOC) in Year 1 (N = 21,365)
Utilization variable Gender of USOC P Male (n = 16,896) Female (n = 4,469) Percentage of total 79.1 20.9 Total healthcare expenditures (thousands of dollars) 5.32 (0.12) 5.15 (0.22) .52 Prescription drug expenditures (thousands of dollars) 1.24 (0.02) 1.20 (0.04) .49 Office visits, n 5.09 (0.07) 5.05 (0.12) .73 Any emergency department visit, % 15.1 (0.4) 14.6 (0.6) .49 Any hospitalization, % 10.9 (0.3) 10.1 (0.5) .19 Values provided as means (standard error). Percentages are population weighted.
- Table 4. Adjusted Associations of Patient and Usual Source of Care (USOC) Characteristics in Year 1 With Total Expenditures in Year 2 (N = 21,365)
Adjusted PE* (95% CI) P Patient characteristics Age, per 10 years 16.43 (13.58–19.36) <.001 Female 1.57 (−5.22 to 8.86) .66 Race/ethnicity Non-Hispanic white Reference Hispanic (any race) −11.55 (−21.13 to −0.80) .04 Non-Hispanic black 6.48 (−6.05 to 20.68) .32 Non-Hispanic other −21.81 (−31.24 to −11.08) <.001 Education level <High school Reference Some high school 5.44 (−6.81 to 19.29) .40 High school graduate 10.14 (−1.79 to 23.53) .10 Some college 23.33 (8.60–40.06) .001 College graduate 39.51 (22.04–59.49) <.001 Household income level, % FPL <100 Reference 100–124 −5.72 (−19.98 to 11.08) .48 125–199 −1.85 (−15.05 to 13.40) .80 200–399 −5.99 (−15.68 to 4.81) .26 ≥400 −1.19 (−11.82 to 10.72) .84 Census region Northeast Reference Midwest 5.48 (−5.41 to 17.62) .34 South −9.27 (−18.28 to 0.72) .07 West 8.45 (−4.52 to 23.19) .21 Urbanicity (residence in MSA) −0.92 (−9.07 to 7.95) .83 Health insurance Private Reference Public −9.23 (−16.47 to −1.37) .02 None −45.18 (−52.66 to −36.52) <.001 Health status (SF-12) Physical Component Summary score −2.06 (−2.54 to −1.58) <.001 Mental Component Summary score −0.70 (−1.06 to −0.34) <.001 Self-rated health Excellent Reference Very good 12.98 (3.49–23.34) .006 Good 27.68 (15.53–41.10) <.001 Fair 60.99 (33.36–94.33) <.001 Poor 94.10 (60.45–134.82) <.001 Chronic health conditions† 15.73 (11.65–19.96) <.001 Body mass index (kg/m2) <20 Reference 20–<25 7.17 (−9.91 to 27.49) .43 25–<30 2.23 (−15.01 to 22.98) .82 ≥30 8.40 (−8.82 to 28.87) .36 Smoker 1.59 (−7.51 to 11.57) .74 Skepticism toward medical care −11.26 (−15.28 to −7.06) <.001 Survey panel year 3.46 (1.62–5.34) <.001 USOC characteristics Specialty Family medicine/general practice Reference General internal medicine 15.25 (5.94–25.38) .001 Subspecialty 11.77 (−1.46 to 26.76) .08 Non-Hispanic white 3.93 (−4.13 to 12.66) .35 Female 4.56 (−3.04 to 12.76) .25 ↵* Adjusted parameter estimate (PE) is from a Poisson regression and represents the percent change in outcome per unit change in predictor variable.
↵† From a count of 8 conditions: diabetes, hypertension, coronary heart disease, myocardial infarction, cerebrovascular disease, asthma, emphysema, and arthritis.
CI, confidence interval; FPL, Federal Poverty Level; MSA, metropolitan statistical area; SF-12, 12-item Short Form.
- Table 5.
Adjusted Associations of Patient and Usual Source of Care (USOC) Characteristics in Year 1 With All-Cause Mortality in Year 2 (N = 11,328)
Adjusted HR* (95% CI) P Patient characteristics Age, per 10 years 2.39 (2.08–2.76) <.001 Female 0.51 (0.38–0.69) <.001 Race/ethnicity (ref = Non-Hispanic white) Non-Hispanic white Reference Hispanic (any race) 0.64 (0.41–1.01) .05 Non-Hispanic black 1.56 (1.01–2.39) .04 Non-Hispanic other 0.87 (0.35–2.16) .77 Education level <High school Reference Some high school 1.03 (0.69–1.55) .88 High school graduate 0.78 (0.51–1.19) .24 Some college 1.20 (0.71–2.02) .50 College graduate 0.66 (0.41–1.07) .09 Household income level, % FPL (ref <100%) <100% Reference 100–124 1.57 (0.90–2.75) .11 125–199 1.29 (0.85–1.98) .23 200–399 1.32 (0.89–1.95) .16 ≥400 1.45 (0.92–2.30) .11 Census region Northeast Reference Midwest 0.85 (0.54–1.34) .48 South 1.03 (0.74–1.43) .86 West 1.26 (0.85–1.89) .25 Urbanicity (residence in MSA) 0.94 (0.68–1.30) .71 Health insurance Private Reference Public 0.94 (0.70–1.26) .67 None 0.64 (0.26–1.57) .33 Health status (SF-12) Physical Component Summary score 0.97 (0.96–0.98) <.001 Mental Component Summary score 0.99 (0.97–1.00) .11 Self-rated health Excellent Reference Very good 1.25 (0.73–2.17) .42 Good 1.42 (0.85–2.37) .17 Fair 2.01 (1.13–3.59) .02 Poor 2.46 (1.26–4.83) .01 Chronic health conditions* 1.06 (0.95–1.18) .31 Body mass index (kg/m2) <20 Reference 20–<25 0.35 (0.23–0.53) <.001 25–<30 0.21 (0.14–0.33) <.001 ≥30 0.21 (0.12–0.36) <.001 Smoker 1.68 (1.16–2.46) .01 Skepticism toward medical care 0.93 (0.76–1.13) .44 Survey panel year 1.14 (0.96–1.36) .13 USOC characteristics Specialty (ref = family medicine/general practice) Family medicine/general practice Reference General internal medicine 1.13 (0.81–1.56) .47 Subspecialty 1.58 (0.92–2.71) .10 Non-Hispanic white 0.86 (0.61–1.21) .39 Female 0.94 (0.64–1.38) .76 ↵* Adjusted hazard ratio (HR) is from a Cox proportional hazards regression limited to respondents enrolled from 2002–2006 (since National Death Index mortality data was available only through December 31, 2006).
†From a count of 8 conditions: diabetes, hypertension, coronary heart disease, myocardial infarction, cerebrovascular disease, asthma, emphysema, and arthritis.
CI, confidence interval; FPL, Federal Poverty Level; HR, hazard ratio; MSA, metropolitan statistical area; SF-12, 12-item Short Form.
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