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Table 8 Adjusted multilevel logistic regression models of health centre and client level factors associated with top quartile delivery of guideline-scheduled counselling or education (for nutrition and physical activity) (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 1.68 (1.38–2.04)** 1.27 (1.03–1.57)* 1.33 (1.08–1.64)**
2008 1.69 (1.41–2.01)** 1.36 (1.11–1.68)** 1.46 (1.18–1.80)**
2009 2.69 (2.24–3.23)** 2.20 (1.76–2.74)** 2.26 (1.81–2.82)**
2010 2.69 (2.22–3.26)** 2.37 (1.82–3.00)** 2.40 (1.89–3.03)**
2011 2.14 (1.80–2.54)** 2.06 (1.62–2.61)** 2.06 (1.62–2.61)**
2012 2.18 (1.83–2.59)** 1.67 (1.27–2.18)** 1.64 (1.26–2.15)**
2013 2.43 (2.86–4.12)** 2.58 (1.93–3.44)** 2.52 (1.89–3.36)**
2014 2.48 (1.98–3.12)** 2.13 (1.54–2.96)** 2.10 (1.51–2.91)**
Health Centre Characteristics
Location X duration of CQI participation
 Non-remote Baseline   1.00 (reference) 1.00 (reference)
1–2 cycles   2.09 (1.72–2.53)** 2.04 (1.68–2.47)**
≥3 cycles   0.92 (0.68–1.25) 0.90 (0.66–1.22)
 Remote Baseline   1.00 (reference) 1.00 (reference)
1–2 cycles   1.27 (0.84–1.91) 1.31 (0.91–1.87)
≥3 cycles   2.41 (1.54–3.79)** 2.47 (1.64–3.74)**
 Governance Community-Controlled   1.00 (reference) 1.00 (reference)
Government operated   0.85 (0.59–1.20) 0.87 (0.62–1.22)
 Service population ≤500   1.00 (reference) 1.00 (reference)
501–999   0.96 (0.66–1.41) 0.95 (0.65–1.39)
≥1000   0.80 (0.56–1.14) 0.81 (0.57–1.14)
 % Clients attending in past 6 months <97 %   1.00 (reference) 1.00 (reference)
≥97 %   1.30 (1.17–1.44)** 1.29 (1.16–1.44)**
Client Characteristics
 Sex Male    1.00 (reference)
Female    1.02 (0.95–1.09)
 Age ≥15- < 25    1.00 (reference)
≥25- < 40    1.29 (0.99–1.70)
≥40- < 55    1.41 (1.08–1.85)*
≥55    1.36 (1.04–1.78)*
 Indigenous Status Non-Indigenous    1.00 (reference)
Indigenous    0.97 (0.83–1.14)
 Comorbidity None    1.00 (reference)
One or more    1.38 (1.27–1.51)**
 Complications No complications    1.00 (reference)
1–2 complications    1.17 (1.05–1.31)**
>2 complications    1.03 (0.86–1.24)
Random effects (intercepts)
  State (variance (SE)) 0.12 (0.12) 0.002 (0.02) 0.0002 (0.005)
MORSTATE 1.38 1.04 1.01
 PCV (% explained variance) - 98 % 100 %
 Health Centre (variance (SE)) 0.77 (0.11) 0.69 (0.10) 0.68 (0.09)
  MORHC 2.31 2.21 2.20
 PCV (% explained variance) - 10 % 12 %
 State & Health Centre (variance) 0.88 0.70 0.68
  MORSTATE-HC 2.45 2.22 2.20
 PCV (% explained variance) - 21 % 23 %
  Patient (variance (SE)) 0.62 (0.12) 0.47 (0.12) 0.27 (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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