Model Results for Sensitivity Analysis Including Chronic Primary Pain, Chronic Neuropathic Pain, and Chronic MSK Pain
| Depression Screening OR (95% CI) | Any Imaging OR (95% CI) | CBC OR (95% CI) | |
|---|---|---|---|
| Patient age (years): | |||
| ≤24 | Reference | Reference | Reference |
| 25 to 44 | 1.94 (0.34, 11.07) | 0.86 (0.69, 1.06) | 2.04 (1.22, 3.40) |
| 45 to 64 | 1.98 (0.34, 11.55) | 0.99 (0.81, 1.21) | 2.85 (1.69, 4.81) |
| 65+ | 2.26 (0.37, 13.97) | 1.06 (0.85, 1.33) | 2.93 (1.73, 4.96) |
| Patient sex: | |||
| Male | Reference | Reference | Reference |
| Female | 1.13 (0.69, 1.86) | 1.16 (1.01, 1.34) | 1.25 (0.97, 1.61) |
| Patient BMI: | |||
| <25 | Reference | Reference | Reference |
| 25 to <30 | 0.87 (0.42, 1.83) | 1.04 (0.81, 1.34) | 0.87 (0.66, 1.16) |
| ≥30 | 0.59 (0.21, 1.62) | 0.93 (0.77, 1.14) | 0.73 (0.53, 1.01) |
| Race/ethnicity: | |||
| Non-Hispanic White | Reference | Reference | Reference |
| Non-Hispanic Black | 2.49 (1.09, 5.66) | 0.91 (0.74, 1.14) | 1.07 (0.77, 1.48) |
| Hispanic | 2.83 (1.26, 6.37) | 0.83 (0.66, 1.05) | 1.51 (1.02, 2.25) |
| Non-Hispanic other | 3.16 (1.12, 8.90) | 1.26 (0.90, 1.75) | 0.56 (0.29, 1.08) |
| Smoking status: | |||
| No tobacco use | Reference | Reference | Reference |
| Current tobacco use | 2.00 (0.86, 4.70) | 0.95 (0.79, 1.13) | 1.09 (0.81, 1.46) |
| Source of payment: | |||
| Self-pay | 0.67 (0.20, 2.19) | 0.70 (0.42, 1.17) | 0.70 (0.33, 1.45) |
| Private insurance | Reference | Reference | Reference |
| Medicare/Medicaid/CHIP | 2.13 (1.13, 4.01) | 1.05 (0.90, 1.22) | 1.14 (0.86, 1.49) |
| Workers' comp | 1.19 (0.23, 6.23) | 1.03 (0.72, 1.47) | 0.26 (0.08, 0.82) |
| Other* | 2.51 (0.82, 7.64) | 0.96 (0.63, 1.46) | 1.13 (0.57, 2.24) |
| No. of past visits:† | |||
| New patient | 0.91 (0.43, 1.94) | 1.67 (1.36, 2.06) | 1.46 (1.00, 2.11) |
| 0 previous visits | 0.75 (0.26, 2.15) | 1.63 (1.25, 2.12) | 0.91 (0.56, 1.49) |
| 1 previous visit | Reference | Reference | Reference |
| 2 to 3 previous visits | 1.03 (0.48, 2.23) | 0.93 (0.77, 1.13) | 0.81 (0.58, 1.13) |
| ≥4 previous visits | 1.21 (0.61, 2.37) | 0.84 (0.68, 1.03) | 0.72 (0.50, 1.03) |
| Physician specialty: | |||
| Family practice | Reference | Reference | Reference |
| Internal medicine | 0.92 (0.50, 1.69) | 1.09 (0.90, 1.34) | 1.33 (0.97, 1.82) |
| Pediatrics | 0.14 (0.05, 0.45) | 2.70 (2.19, 3.33) | 0.07 (0.04, 0.14) |
| Orthopedic surgery | 1.16 (0.10, 13.63) | 1.26 (0.87, 1.82) | 1.64 (0.82, 3.26) |
| Neurology | 0.70 (0.18, 2.74) | 0.83 (0.60, 1.16) | 0.31 (0.16, 0.58) |
| Oncology | 1.77 (0.18, 17.79) | 2.27 (0.69, 7.48) | 3.50 (1.09, 11.25) |
| Others | 0.26 (0.09, 0.73) | 0.97 (0.77, 1.23) | 0.63 (0.40, 1.01) |
| Degree: | |||
| MD | Reference | Reference | Reference |
| DO | 0.41 (0.19, 0.89) | 0.85 (0.70, 1.02) | 0.85 (0.64, 1.14) |
| Practice type: | |||
| Solo | Reference | Reference | Reference |
| Nonsolo/group | 1.46 (0.81, 2.64) | 1.27 (1.09, 1.48) | 0.98 (0.74, 1.31) |
| EMR: | |||
| All electronic | 1.93 (0.65, 5.71) | 1.05 (0.87, 1.27) | 0.83 (0.63, 1.10) |
| Part electronic/paper | 1.04 (0.31, 3.53) | 0.89 (0.70, 1.14) | 1.00 (0.68, 1.47) |
| No electronic | Reference | Reference | Reference |
| Chronic primary pain: | |||
| Yes | 2.68 (1.41, 5.09) | 0.64 (0.43, 0.97) | 0.62 (0.32, 1.20) |
| No | Reference | Reference | Reference |
| Chronic neuropathic pain: | |||
| Yes | 0.06 (0.01, 0.52) | 1.23 (0.57, 2.66) | 0.48 (0.17, 1.32) |
| No | Reference | Reference | Reference |
| Chronic MSK pain: | |||
| Yes | 1.28 (0.50, 3.27) | 1.99 (1.26, 3.12) | 0.35 (0.19, 0.64) |
| No | Reference | Reference | Reference |
| Survey year: | |||
| 2007 | Reference | Reference | Reference |
| 2008 | 0.41 (0.08, 2.16) | 1.07 (0.77, 1.50) | 1.16 (0.72, 1.88) |
| 2009 | 0.24 (0.04, 1.49) | 0.88 (0.66, 1.18) | 0.81 (0.49, 1.34) |
| 2010 | 0.42 (0.08, 2.19) | 0.92 (0.63, 1.35) | 0.99 (0.63, 1.56) |
| 2011 | 0.35 (0.10, 1.21) | 1.06 (0.78, 1.45) | 1.64 (1.05, 2.56) |
| 2012 | 0.56 (0.17, 1.84) | 0.68 (0.50, 0.91) | 0.93 (0.62, 1.38) |
| 2013 | 0.52 (0.17, 1.58) | 0.63 (0.46, 0.86) | 1.10 (0.70, 1.71) |
| 2014 | 1.07 (0.31, 3.74) | 0.77 (0.57, 1.04) | 1.19 (0.75, 1.90) |
| 2015 | 1.53 (0.41, 5.73) | 0.77 (0.54, 1.10) | 1.48 (0.75, 2.91) |
↵* Source of payment other: charity, unknown, other.
↵† Number of past visits: number of visits in the past 12 months to the practice for other problems (excludes index visit). New patient by definition is a new patient to that clinic and could not have any past visits, while a regular patient of the clinic who has 0 visits means they were an established patient but did not see the physician for any problem in the previous 12 months.
BMI, body mass index; CBC, complete blood count; CHIP, Children's Health Insurance Program; CI, confidence interval; EMR, electronic medical record; MSK, musculoskeletal; OR, odds ratio.