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Table 7 Adjusted multilevel regression analysis of health centre and patient level factors on delivery of guideline scheduled Type 2 diabetes services (n = 10,674 clients; 132 health centres)

From: Duration of participation in continuous quality improvement: a key factor explaining improved delivery of Type 2 diabetes services

Outcome is >76% service delivery Empty Model A Model B Model C
Predictors Fixed effects OR 95% CI OR 95% CI OR 95% CI
Audit Year 2005/2006 1.00 (reference) 1.00 (reference) 1.00 (reference)
  2007 1.62 (1.32-1.98)*** 1.14 (0.91-1.44) 1.20 (0.95-1.51)
  2008 1.90 (1.57-2.32)*** 1.21 (0.95-1.54) 1.30 (1.02-1.67)*
  2009 2.41 (1.99-2.93)*** 1.35 (1.03-1.77)* 1.40 (1.07-1.83)*
  2010 2.23 (1.80-2.76)*** 1.16 (0.86-1.57) 1.17 (0.86-1.59)
  2011 2.40 (1.97-2.93)*** 1.25 (0.92-1.71) 1.24 (0.91-1.69)
  2012 2.89 (2.37-3.53)*** 1.18 (0.82-1.68) 1.17 (0.82-1.67)
Health Centre Characteristics       
Location X duration of CQI participation       
Non-remote: Baseline    1.00 (reference) 1.00 (reference)
  1-2 cycles    1.53 (1.10-2.11)* 1.47 (1.06-2.04)*
  ≥3 cycles    1.62 (1.02-2.55)* 1.55 (0.98-2.45)
Remote: Baseline    1.00 (reference) 1.00 (reference)
  1-2 cycles    2.92 (1.36-6.24)** 2.91 (1.36-6.22)**
  ≥3 cycles    3.14 (1.37-7.18)** 3.29 (1.44-7.54)**
Very Remote: Baseline    1.00 (reference) 1.00 (reference)
  1-2 cycles    4.03 (2.27-7.16)*** 4.31 (2.43-7.67)***
  ≥3 cycles    4.72 (2.47-9.02)*** 5.05 (2.63-9.67)***
Patient attendance in last 6 months Lower attendance    1.00 (reference) 1.00 (reference)
Higher attendance    1.40 (1.22-1.60)*** 1.40 (1.22-1.61)***
Patient Characteristics (Age X disease status)     
≥15- <-25 years: Comorbidity One condition      1.00 (reference)
2 or more conditions      1.83 (0.85-3.94)
≥15- <-25 years: Complications None      1.00 (reference)
1-2 complications      0.87 (0.13-5.68)
  >2 complications      5.82 (0.45-74.5)
≥25- <-40 years: Comorbidity One condition      1.00 (reference)
2 or more conditions      1.38 (1.10-1.73)**
≥25- <-40 years: Complications None      1.00 (reference)
1-2 complications      2.40 (1.53-3.77)***
  >2 complications      1.73 (0.72-4.13)
≥40- <-55 years: Comorbidity One condition      1.00 (reference)
2 or more conditions      1.43 (1.20-1.69)***
≥40- <-55 years: Complications None      1.00 (reference)
1-2 complications      1.32 (1.05-1.65)*
  >2 complications      1.17 (0.80-1.70)
≥55 years: Comorbidity One condition      1.00 (reference)
2 or more conditions      1.26 (1.05-1.52)*
≥55 years: Complications None      1.00 (reference)
1-2 complications      1.29 (1.05-1.58)*
  >2 complications      1.45 (1.04-2.01)*
Random effects (intercepts)       
State (variance (SE)) 1.41 (0.99) 0.72 (0.53) 0.69 (0.51)
  MOR STATE 3.10   2.24   2.21  
PCV (% explained variance)    49%   51%  
Health Centre (variance (SE)) 1.21 (0.19) 0.93 (0.15) 0.94 (0.15)
  MOR HC 2.86   2.51   2.52  
PCV (% explained variance)    23%   23%  
State & Health Centre (variance) 2.62   1.65   1.63  
  MOR STATE-HC 4.68   3.41   3.38  
PCV (% explained variance)    37%   38%  
Patient (variance (SE)) 0.13 (0.072) 0.07 (0.03) 0.02 (0.012)
PCV (% explained variance)    44%   81%  
  1. *p <-0.05; **p <-0.01; ***p <-0.0001.
  2. MOR (Median odds ratio): odds of receiving `top quartile service delivery’ if a patient was to change health centre or jurisdiction [17].
  3. PCV (Proportional change in variance): percent variation explained in odds for better health care delivery by introduction of health centre or patient level factors [16].