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Table 5 Ecological regression results, managed care interaction

From: Macro-level factors impacting geographic disparities in cancer screening

 

BC screening, 2003-2005

CRC screening, 2001-2005

 

Base model

Interactions

Base model

Interactions

Variable

Coeff

Pval

Coeff

Pval

Coeff

Pval

Coeff

Pval

% Age 75-84 in FFS Medicare

-0.081

0.036

-0.081

0.035

0.010

0.773

0.009

0.785

% Age 85+ in FFS Medicare

-0.299

0.000

-0.295

0.000

-0.462

0.000

-0.455

0.000

% Dual or ESRD in FFS Medicare

-0.381

0.000

-0.383

0.000

-0.264

0.000

-0.266

0.000

% Black in FFS Medicare

0.107

0.000

0.107

0.000

0.076

0.000

0.076

0.000

% Hispanic in FFS Medicare

0.038

0.404

0.036

0.420

-0.016

0.624

-0.015

0.651

% Other race in FFS Medicare

-0.151

0.000

-0.147

0.000

0.030

0.136

0.034

0.098

% Mover in 2001-2005 in FFS Medicare

0.177

0.000

0.175

0.000

0.062

0.000

0.062

0.000

Average distance to closest provider

-0.035

0.000

-0.034

0.000

-0.040

0.000

-0.039

0.000

managed care penetration

-0.016

0.131

0.190

0.005

0.033

0.000

0.217

0.000

Population density in 2001 (in thousands)

-0.133

0.035

-0.133

0.034

0.100

0.054

0.099

0.055

% US population in poverty in 2001

-0.099

0.019

-0.092

0.029

-0.168

0.000

-0.161

0.000

% states allowing NP to practice and/or prescribe

-0.109

0.935

-0.112

0.934

-0.996

0.276

-1.003

0.283

% of counties with MD Shortage

-0.204

0.134

-0.202

0.140

0.075

0.422

0.076

0.423

% of Medicare population with Supplemental MediGap

-0.088

0.230

-0.084

0.256

-0.019

0.703

-0.016

0.757

REG 1 (R14 = 1, R25 = 1)1

1.198

0.560

1.842

0.377

3.771

0.007

4.379

0.002

REG 2 (R14 = 1)1

1.358

0.578

2.024

0.415

2.370

0.155

2.824

0.102

Interaction REG1 with managed care penetration

  

-0.210

0.002

  

-0.188

0.001

Interaction REG2 with managed care penetration

  

-0.213

0.003

  

-0.180

0.002

Sum of direct and indirect tests

BC Model

 

CRC Model

 

Joint effect

p-value

 

Joint effect

p-value

Effects of increasing managed care penetration in REG1 states vs Unregulated states

-0.020

0.098

 

0.029

0.003

Effects of increasing managed care penetration in REG2 states vs Unregulated states

-0.023

0.347

 

0.037

0.060

Effects of increasing managed care penetration in Unregulated states

0.190

0.005

 

0.217

0.000

  1. 1We defined three insurance regulatory ‘regimes’ based on the combination of the two state insurance regulatory variables (R14, external review and R25, continuity of care).
  2. Regime 1 (REG1) was defined as having both regulations in place (R14 = 1, R25 = 1). Regime 2 (REG2) was defined as having only one of these regulations in place (R14 = 1). Regime 3 (REG3) was the reference group in the estimation; it included all other states, which had neither regulation. See Table 7 for Regime Membership by States. Bold font indicates statistical significance at 95% confidence level.