Table 1 Distribution of characteristics by Guideline Concordance of Prescribing Decision^a

Main Independent Variable

 Dental Setting

  Non-VA

42,832 (70.1)

14,351 (71.7)

28,481 (69.3)

Reference

9.507 (69.5)

4,844 (71.4)

Reference

  VA

18,292 (29.9)

5,663 (28.3)

12,629 (30.7)

0.92 (0.90–0.95)

4,174 (30.5)

1,812 (28.6)

1.12 (1.08–1.16)

Demographics & Clinical Characteristics

 Mean Age (SD)

59.1 (10.4)

56.8 (13.1)

60.0 (12.0)

1.00 (0.99–1.00)

56.7 (14.0)

56.7 (12.4)

1.00 (0.99–1.00)

 Age Group

  18–24

1,799 (2.9)

1,550 (7.7)

249 (0.6)

Reference

1,155 (8.4)

395 (8.4)

Reference

  35–44

2,361 (3.9)

1,430 (7.1)

931 (2.3)

0.70 (0.68–0.73)

952 (7.0)

478 (7.6)

0.89 (0.85–0.94)

  45–54

10,382 (17.0)

3,752 (18.8)

6,630 (16.1)

0.42 (0.41–0.43)

2,522 (18.4)

1,230 (19.4)

0.90 (0.87–0.94)

  55–64

33,641 (55.0)

8,992 (43.9)

24,649 (60.0)

0.31 (0.30–0.32)

5,890 (43.1)

3,102 (49.0)

0.88 (0.85–0.91)

  65 + 

12,941 (21.2)

34,290 (22.4)

8.651 (21.0)

0.38 (0.37–0.40)

3,162 (23.1)

1,128 (17.8)

0.99 (0.96–1.02)

 Sex

  Male

37,253 (61.0)

12.366 (61.8)

24,887 (60.5)

Reference

8,747 (63.9)

3,619 (57.2)

Reference

  Female

23,871 (39.0)

7,648 (38.2)

16,223 (39.5)

0.97 (0.94–0.99)

4,934 (36.1)

2,714 (428)

0.91 (0.89–0.93)

 Cardiac Condition or Prosthetic Joint

  Cardiac Condition

15,707 (25.7)

14,107 (70.5)

1,600 (3.9)

Reference

9,586 (70.1)

4,521 (71.4)

Reference

  Prosthetic Joint

38,445 (62.9)

0 (0.0)

38,445 (93.5)

–

–

–

–

  Both

6,972 (11.4)

5,907 (29.5)

1,065 (2.6)

0.94 (0.93–0.95)

4,095 (29.9)

1,812 (28.6)

1.02 (0.99–1.04)

 Region

  Northeast

7,901 (12.9)

2,915 (14.6)

4,986 (12.1)

Reference

1,864 (13.6)

1,051 (16.6)

Reference

  Midwest

22,780 (37.3)

6,893 (34.4)

15,887 (38.7)

0.82 (0.79–0.85)

2,998 (36.5)

1,895 (29.9)

1.13 (1.10–1.17)

  South

22,635 (37.0)

7,766 (38.8)

14,869 (36.2)

0.93 (0.90–0.96)

5,268 (38.5)

2,498 (39.4)

1.06 (1.03–1.09)

  West

7,808 (12.8)

2,440 (12.2)

5,368 (13.0)

0.85 (0.81–0.88)

1,551 (11.3)

889 (14.0)

0.99 (0.95–1.04)

 Location

  Rural

9,659 (15.8)

2,829 (14.1)

6,830 (16.6)

Reference

2,181 (15.9)

648 (10.2)

Reference

  Urban

51,465 (84.2)

17,185 (85.9)

34,280 (83.4)

1.14 (1.10–1.18)

11,500 (84.1)

5,685 (89.8)

0.87 (0.85–0.89)

 Year

  2015

20,684 (33.8)

6,684 (33.4)

14,000 (34.1)

Reference

4,594 (33.6)

2,090 (33.0)

Reference

  2016

20,745 (22.9)

6,803 (34.0)

13,942 (33.9)

1.01 (0.99–1.04)

2,641 (33.9)

2,162 (34.1)

0.99 (0.97–1.12)

  2017

19,695 (32.3)

6,527 (32.6)

13,168 (32.0)

1.03 (0.98–1.05)

4,446 (32.5)

2,081 (32.9)

0.99 (0.97–1.01)

Comorbidities

 Mean Charlson (SD)

0.91 (1.5)

1.2 (1.3)

0.75 (1.8)

1.21 (1.20–1.22)

1.23 (1.8)

1.22 (1.8)

1.00 (0.99–1.01)

 Myocardial Infarction

  No

60,217 (98.5)

19,437 (97.2)

40,780 (99.2)

Reference

13,300 (97.2)

6,137 (96.9)

Reference

  Yes

907 (1.5)

577 (2.8)

330 (0.8)

1.97 (1.87–2.07)

381 (2.8)

196 (3.1)

0.96 (0.91–1.02)

 Congestive Heart Failure

  No

56,315 (92.1)

16,633 (83.1)

39,682 (96.5)

Reference

11,311 (82.7)

5,322 (84.0)

Reference

  Yes

4,809 (7.9)

3,381 (16.9)

1,428 (3.5)

2.38 (2.33–2.43)

2,370 (17.3)

1,011 (16.0)

1.03 (1.01–1.06)

 Peripheral Vascular Disease

  No

57,330 (93.8)

17,856 (89.2)

29,474 (96.0)

Reference

12,197 (89.2)

5,659 (89.4)

Reference

  Yes

3,794 (6.2)

2,158 (10.8)

1,636 (4.0)

1.83 (1.77–1.88)

1,484 (10.8)

674 (10.6)

1.01 (0.98–1.04)

 Cerebrovascular Disease

  No

58,824 (96.2)

18,611 (93.0)

40,213 (97.8)

Reference

12,725 (93.0)

5,886 (92.9)

Reference

  Yes

2,300 (3.8)

1,403 (7.0)

897 (2.2)

1.93 (1.86–2.00)

956 (7.0)

447 (7.1)

00.99 (0.96–1.03)

 Dementia

  No

60,811 (99.5)

19.852 (99.2)

40,959 (99.6)

Reference

13,558 (99.1)

6,294 (99.4)

Reference

  Yes

313 (0.5)

162 (0.8)

151 (0.4)

1.59 (1.42–1.76)

123 (0.9)

39 (0.6)

1.11 (1.02–1.21)

 COPD

  No

53,515 (87.6)

17,160 (85.7)

36,355 (88.4)

Reference

11,751 (85.9)

5,409 (85.4)

Reference

  Yes

7,609 (12.4)

2,854 (14.3)

4,755 (11.6)

1.17 (1.13–1.21)

1,930 (14.1)

924 (14.6)

0.99 (0.96–1.01)

 Connective Tissue Disease

  No

59,172 (96.8)

19,427 (97.1)

39,745 (96.7)

Reference

13,288 (97.1)

6,139 (96.9)

Reference

  Yes

1,952 (3.2)

587 (2.9)

1,365 (3.3)

0.92 (0.86–0.98)

393 (2.9)

194 (3.1)

0.98 (0.92–1.04)

 Peptic Ulcer Disease

  No

60,657 (99.2)

19,832 (99.1)

40,825 (99.3)

Reference

13,553 (99.1)

6,279 (99.2)

Reference

  Yes

467 (0.8)

182 (0.9)

285 (0.7)

1.19 (1.06–1.34)

128 (0.9)

54 (0.8)

1.03 (0.94–1.13)

 Liver Disease

  No

59,063 (96.6)

19,182 (95.8)

39,881 (97.0)

Reference

13.150 (96.1)

6,032 (95.3)

Reference

  Mild

1,534 (2.5)

582 (2.9)

952 (2.3)

1.17 (1.09–1.25)

358 (2.6)

224 (3.5)

0.90 (0.84–0.96)

  Moderate to Severe

527 (0.9)

250 (1.3)

277 (0.7)

1.46 (1.33–1.60)

173 (1.3)

77 (1.2)

1.91 (0.93–1.10)

 Diabetes

  No

51.932 (85.0)

16,942 (84.6)

34,990 (85.1)

Reference

11,600 (84.8)

5,342 (84.4)

Reference

  Uncomplicated

6,880 (11.3)

2,132 (10.7)

4,748 (11.6)

0.95 (0.92–0.99)

1,433 (10.5)

699 (11.0)

0.98 (0.95–1.02)

  Complicated

2,312 (3.7)

940 (4.7)

1,372 (3.3)

1.25 (1.18–1.31)

648 (4.7)

292 (4.6)

1.01 (0.96–1.05)

 Paraplegia/Hemiplegia

  No

60,826 (99.5)

19,857 (99.2)

40,969 (99.7)

Reference

113,575 (99.2)

6,282 (99.2)

Reference

  Yes

298 (0.5)

157 (0.8)

141 (0.3)

1.61 (1.45–1.80)

106 (0.8)

51 (0.8)

0.99 (0.89–1.10)

 Renal Disease

  No

56,615 (92.6)

17,850 (89.2)

38,765 (94.3)

Reference

12,161 (88.9)

5,689 (89.8)

Reference

  Yes

4,509 (7.4)

2,164 (10.8)

2,345 (5.7)

1.52 (1.47–1.57)

1,520 (11.1)

6444 (10.2)

1.03 (1.00–1.06)

 Cancer

  No

57,490 (94.1)

18,752 (93.7)

38,738 (94.2)

Reference

12,818 (93.7)

5,934 (93.7)

Reference

  Yes

3,634 (5.9)

1,262 (6.3)

2,372 (5.8)

1.06 (1.02–1.11)

863 (6.3)

399 (6.3)

1.00 (0.96–1.04)

 Metastatic Solid Tumor

  No

60,801 (99.5)

19.889 (99.4)

40,912 (99.5)

Reference

13,595 (99.4)

6,294 (99.4)

Reference

  Yes

323 (0.5)

125 (0.6)

198 (0.5)

1.18 (1.03–1.36)

86 (0.6)

39 (0.6)

1.01 (0.89–1.13)

 AIDS

  No

61,035 (99.9)

19,977 (99.8)

41,058 (99.9)

Reference

13,656 (99.8)

6,321 (99.8)

Reference

  Yes

89 (0.1)

37 (0.2)

52 (0.1)

1.27 (0.99–1.63)

25 (0.2)

12 (0.2)

0.99 (0.79–1.24)

Dental Procedures

 Gingival Manipulation

  No

7,505 (12.3)

0 (0.0)

7,505 (18.3)

Reference

–-^b

–-

–-

  Yes

53,619 (87.7)

20,014 (100.0)

33,605 (81.7)

–-

–-

–-

–-

 Adjunctive

  No

57,368 (93.9)

19,063 (95.2)

38.305 (93.2)

Reference

13,051 (95.4)

6,012 (94.9)

Reference

  Yes

2,756 (6.1)

951 (4.8)

2,805 (6.8)

0.76 (0.72–0.81)

630 (4.6)

321 (5.1)

0.97 (0.92–1.01)

 Diagnostic

  No

17,585 (28.8)

4,360 (21.8)

13.225 (32.2)

Reference

2,967 (21.7)

1,393 (22.0)

Reference

  Yes

43,539 (72.2)

15,654 (78.2)

27.,885 (67.8)

1.45 (1.41–1.49)

10.714 (78.3)

4,940 (78.0)

1.01 (0.98–1.03)

 Endodontics

  No

59,690 (97.7)

19.530 (97.6)

0.410

Reference

13,367 (97.7)

6,163 (97.3)

Reference

  Yes

1,434 (2.3)

484 (2.4)

950 (2.3)

1.04 (0.96–1.11)

314 (2.3)

170 (2.7)

0.95 (0.89–1.01)

 Implant

  No

60,268 (98.6)

19.756 (98.8)

40,512 (98.5)

Reference

13,520 (98.8)

6,236 (98.5)

Reference

  Yes

856 (1.4)

258 (1.3)

598 (1.5)

0.92 (0.83–1.02)

161 (1.2)

97 (1.5)

0.91 (0.83–1.00)

 Maxillofacial Prosthetics

  No

61,082 (99.9)

20,005 (99.9)

41,077 (99.9)

Reference

13.675 (99.9)

6,330 (99.9)

Reference

  Yes

42 (0.1)

9 (0.1)

33 (0.1)

0.65 (0.37–1.17)

6 (0.1)

3 (0.1)

0.98 (0.61–1.55)

 Oral Maxillofacial Surgery

  No

57,435 (94.0)

18,545 (92.7)

28,890 (94.6)

Reference

12,703 (92.8)

5,842 (92.3)

Reference

  Yes

3,689 (6.0)

1,469 (7.3)

2,220 (5.4)

1.23 (1.18–1.29)

978 (7.2)

491 (7.8)

0.97 (0.94–1.01)

 Orthodontics

  No

61,054 (99.9)

19,999 (99.9)

41,055 (99.9)

Reference

13,670 (99.9)

6,329 (99.9)

Reference

  Yes

70 (0.1)

15 (0.1)

55 (0.1)

0.65 (0.42–1.02)

11 (0.1)

4 (0.1)

1.08 (0.79–1.46)

 Periodontics

  No

56,376 (92.2)

18,275 (91.3)

38,101 (92.7)

Reference

12,535 (91.6)

5,740 (90.6)

Reference

  Yes

4,748 (7.8)

1,739 (8.7)

3,009 (7.3)

1.13 (1.09–1.18)

1,146 (8.4)

593 (9.4)

0.96 (0.93–1.00)

 Preventive

  No

31,436 (51.4)

9,192 (45.9)

22,244 (54.1)

Reference

6,334 (46.3)

2,858 (45.1)

Reference

  Yes

29,688 (48.6)

10,822 (54.1)

18,866 (45.9)

1.25 (1.22–1.27)

7,347 (53.7)

2,475 (55.9)

0.99 (0.97–1.00)

 Prosthodontics

  No

59,060 (96.6)

19,594 (97.9)

39,466 (96.0)

Reference

13,399 (97.9)

6,195 (97.8)

Reference

  Yes

2,064 (3.4)

420 (2.1)

1,644 (4.0)

0.61 (0.56–0.67)

282 (2.1)

138 (2.2)

0.98 (0.91–1.05)

 Fixed Prosthodontics

  No

60,327 (98.7)

19,920 (99.5)

40.407 (98.3)

Reference

13,617 (99.5)

6,303 (99.5)

Reference

  Yes

797 (1.3)

94 (0.5)

703 (1.7)

0.36 (0.29–0.43)

64 (0.5)

30 (0.5)

1.00 (0.87–1.14)

 Restorative

  No

46,350 (75.8)

16,184 (80.7)

30,202 (73.5)

Reference

11,047 (80.8)

5,101 (80.6)

Reference

  Yes

14,774 (24.2)

3.866 (19.3)

10,908 (26.5)

0.75 (0.73–0.77)

2,634 (19.2)

1,232 (19.4)

1.00 (0.97–1.02)

 Uncategorized

  No

60,717 (99.3)

19,913 (99.5)

40,804 (99.3)

Reference

13,607 (99.5)

6,306 (99.6)

Reference

  Yes

407 (0.7)

101 (0.5)

306 (0.7)

0.76 (0.64–0.90)

74 (0.5)

27 (0.4)

1.07 (0.95–1.21)