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Table 7 Adjusted multilevel logistic regression models of health centre and client level factors associated with top quartile delivery of guideline-scheduled specialist physical checks (N = 15,622 clients, 162 health centres)

From: Improvement in delivery of type 2 diabetes services differs by mode of care: a retrospective longitudinal analysis in the Aboriginal and Torres Strait Islander Primary Health Care setting

 

Model A empty

Model B adjusted

Model C adjusted

 

Fixed effects

OR (95 % CI)

ORs (95 % CI)

ORs (95 % CI)

Audit Year

2005/2006

1.00 (reference)

1.00 (reference)

1.00 (reference)

2007

0.88 (0.72–1.08)

0.74 (0.60–0.91)**

0.75 (0.60–0.93)**

2008

0.95 (0.80–1.13)

0.78 (0.63–0.96)*

0.83 (0.67–1.03)

2009

1.26 (1.04–1.51)*

1.02 (0.82–1.27)

1.05 (0.84–1.32)

2010

1.06 (0.87–1.29)

0.86 (0.68–1.09)

0.86 (0.68–1.10)

2011

1.02 (0.85–1.21)

0.87 (0.69–1.10)

0.86 (0.67–1.09)

2012

1.29 (1.08–1.53)*

0.95 (0.73–1.24)

0.95 (0.72–1.25)

2013

1.64 (1.36–1.97)**

1.16 (0.87–1.54)

1.09 (0.82–1.46)

2014

1.65 (1.30–2.08)**

1.21 (0.87–1.68)

1.13 (0.81–1.57)

Health Centre Characteristics

Location X duration of CQI participation

 Non-remote

Baseline

 

1.00 (reference)

1.00 (reference)

1–2 cycles

 

1.59 (1.32–1.91)**

1.53 (1.26–1.84)**

≥3 cycles

 

1.26 (0.93–1.71)

1.20 (0.88–1.65)

 Remote

Baseline

 

1.00 (reference)

1.00 (reference)

1–2 cycles

 

1.24 (0.91–1.68)

1.36 (0.99–1.85)

≥3 cycles

 

1.55 (1.07–2.24)*

1.70 (1.16–2.47)**

 Governance

Community-Controlled

 

1.00 (reference)

1.00 (reference)

Government operated

 

0.89 (0.66–1.20)

0.93 (0.68–1.26)

 Service population

≤500

 

1.00 (reference)

1.00 (reference)

501–999

 

0.94 (0.70–1.26)

0.94 (0.70–1.27)

≥1000

 

0.86 (0.65–1.12)

0.86 (0.65–1.14)

 % Clients attending in past 6 months

<97 %

 

1.00 (reference)

1.00 (reference)

≥97 %

 

1.47 (1.32–1.64)**

1.46 (1.31–1.62)**

Client Characteristics

 Sex

Male

  

1.00 (reference)

Female

  

1.14 (1.06–1.23)**

 Age

≥15- < 25

  

1.00 (reference)

≥25- < 40

  

1.40 (1.07–1.83)*

≥40- < 55

  

1.92 (1.48–2.51)**

≥55

  

2.66 (2.04–3.47)**

 Indigenous Status

Non-Indigenous

  

1.00 (reference)

Indigenous

  

1.23 (1.05–1.45)*

 Comorbidity

None

  

1.00 (reference)

One or more

  

1.35 (1.24–1.47)**

 Disease severity

No complications

  

1.00 (reference)

1–2 complications

  

2.34 (2.06–2.67)**

>2 complications

  

3.08 (2.45–3.88)**

Random effects (intercepts)

 

State (variance (SE))

0.36 (0.26)

0.18 (0.14)

0.18 (0.14)

MORSTATE

1.77

1.49

1.49

 PCV (% explained variance)

-

49 %

51 %

 Health Centre (variance (SE))

0.49 (0.07)

0.38 (0.06)

0.40 (0.06)

 

MORHC

1.95

1.80

1.83

 PCV (% explained variance)

-

23 %

19 %

 State & Health Centre (variance)

0.85

0.56

0.57

 

MORSTATE-HC

2.41

2.03

2.06

 PCV (% explained variance)

-

34 %

32 %

 

Patient (variance (SE))

1.21 (0.35)

1.00 (0.27)

0.26 (0.08)

  1. MOR (Median odds ratio): odds of receiving ‘top quartile’ service delivery if patient was to change health centre or jurisdiction; PCV (Proportional change in variance): percent variation explained in odds for better health care delivery by introduction of health centre or patient level factors
  2. *p < 0.05
  3. **p = <0.01
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BMC Health Services Research

ISSN: 1472-6963

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