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Table 3 Bivariate analysis of referred versus not referred vignette patients (n = 680 decisions)

From: Patient and provider determinants of nephrology referral in older adults with severe chronic kidney disease: a survey of provider decision making

 

Referred

(n = 423)

Not Referred

(n = 257)

P value

Patient Characteristics

   

Older Age, (%)

44.7

58.8

< 0.001*

Female gender, (%)

50.4

49.2

0.81

Black race, (%)

51.3

47.9

0.38

Presence of stage III CHF, (%)

50.1

49.8

0.94

Ambulation with walker, (%)

49.2

51.4

0.58

Presence of moderate dementia, (%)

41.4

68.1

0.01*

PCP Demographics

   

Older Age, mean (SD)

50.3 (9.89)

49.2 (9.26)

0.14

Non-white race, (%)

13.2

4.1

< 0.001*

Female gender, (%)

27.9

13.2

< 0.001*

OKPRN, (%)

75.4

84.4

0.01*

Urban practice, (%)

64.3

56.0

0.03*

Foreign Medical School Graduate, (%)

13.7

12.5

0.03*

PCP Experience

   

Estimation of Remaining Life Expectancy, mean (SD)

6.11 (3.53)

5.38 (4.15)

0.02*

Report of knowledge of KDOQI guidelines, (%)

75.7

77.11

0.67

Importance of Patient Age, (%)

13.71

21.01

0.01*

Importance of Patient Race, (%)

4.73

1.56

0.03*

Importance of Co-morbidities, (%)

46.81

44.36

0.53

 

28.13

31.52

0.35

Importance of Patient Cognitive Status, (%)

26.00

44.36

< 0.001*

Importance of Severity of CKD, (%)

76.60

57.59

< 0.001*

Estimated proportion of patients over age 65, mean (SD)

0.27 (0.44)

0.37 (0.48)

0.01*

More than 10 patients referred to nephrology in last 1 year, (%)

52.01

32.73

< 0.001*

PCP Expectations

   

Expectation that nephrologist would evaluate etiology of CKD, (%)

63.00

37.00

0.01*

Expectation that nephrologist would manage blood pressure, (%)

63.29

36.67

0.65

Expectation that nephrologist would treat anemia, (%)

62.34

37.71

0.96

Expectation that nephrologist would discuss prognosis, (%)

62.19

37.83

0.98

Expectation that nephrologist would discuss initiation of dialysis, (%)

62.10

38.02

0.49

Expectation that nephrologist would discuss goals of care, (%)

63.40

36.60

0.001*

PCP Reaction to Uncertainty and Risk Aversion

   

Anxiety about uncertainty†, mean (SD)

16.75 (4.20)

16.11 (3.78)

0.04*

Concern about bad outcomes‡, mean (SD)

8.84 (3.55)

8.40 (3.66)

0.12

Reluctance to disclose uncertainty to patients§, mean (SD)

17.47 (3.99)

17.85 (3.19)

0.20

Reluctance to disclose uncertainty to other providers¢, mean (SD)

4.54 (2.14)

4.45 (1.57)

0.54

Risk aversion, n (%)

77.8

68.1

0.01*

  1. * Values reaching significance level p < 0.05; The Physician Reaction to Uncertainty Scale subscale ranges are †6-30 points, ‡ 3-18 points, § 6-30 points, and ¢ 2-12 points