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Table 9 Adjusted multilevel logistic regression models of health centre and client level factors associated with top quartile delivery of guideline-scheduled counselling or education (for smoking and alcohol risk reduction amongst high risk users) (N = 5496 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

3.30 (2.23–4.88)**

2.67 (1.77–4.03)**

2.80 (1.85–4.22)**

2008

2.32 (1.67–3.21)**

1.87 (1.31–2.67)**

1.96 (1.37–2.81)**

2009

2.33 (1.71–3.18)**

1.90 (1.34–2.69)**

1.96 (1.38–2.78)**

2010

2.21 (1.59–3.09)**

1.88 (1.30–2.74)**

1.90 (1.31–2.76)**

2011

2.25 (1.66–3.05)**

1.99 (1.41–2.82)**

2.01 (1.42–2.85)**

2012

2.25 (1.67–3.02)**

1.74 (1.19–2.54)**

1.75 (1.20–2.56)**

2013

2.76 (2.03–3.76)**

2.06 (1.39–3.06)**

2.07 (1.40–3.07)**

2014

2.41 (1.67–3.45)**

1.81 (1.15–2.86)*

1.82 (1.16–2.88)**

Health Centre Characteristics

Location X duration of CQI participation

 Non-remote

Baseline

 

1.00 (reference)

1.00 (reference)

1–2 cycles

 

1.83 (1.29–2.59)**

1.78 (1.26–2.53)**

≥3 cycles

 

1.71 (1.01–2.89)*

1.64 (0.97–2.77)

 Remote

Baseline

 

1.00 (reference)

1.00 (reference)

1–2 cycles

 

0.94 (0.65–1.35)

0.93 (0.65–1.35)

≥3 cycles

 

1.03 (0.61–1.75)

1.04 (0.62–1.76)

 Governance

Community-Controlled

 

1.00 (reference)

1.00 (reference)

Government operated

 

0.67 (0.50–0.91)*

0.69 (0.51–0.94)*

 Service population

≤500

 

1.00 (reference)

1.00 (reference)

501–999

 

0.92 (0.67–1.27)

0.92 (0.66–1.27)

≥1000

 

0.99 (0.74–1.34)

1.00 (0.74–1.35)

 % Clients attending in past 6 months

<97 %

 

1.00 (reference)

1.00 (reference)

≥97 %

 

1.06 (0.90–1.26)

1.05 (0.88–1.24)

Client Characteristics

 Sex

Male

  

1.00 (reference)

Female

  

1.00 (0.88–1.13)

 Age

≥15- < 25

  

1.00 (reference)

≥25- < 40

  

0.90 (0.57–1.42)

≥40- < 55

  

0.97 (0.62–1.53)

≥55

  

0.92 (0.58–1.45)

 Indigenous Status

Non-Indigenous

  

1.00 (reference)

Indigenous

  

1.07 (0.76–1.51)

 Comorbidity

None

  

1.00 (reference)

One or more

  

1.23 (1.06–1.43)**

 Disease severity

No complications

  

1.00 (reference)

1–2 complications

  

1.10 (0.90–1.35)

>2 complications

  

1.17 (0.84–1.64)

Random effects (intercepts)

 

State (variance (SE))

0.01 (0.02)

0.00007 (0.001)

0.00008 (0.001)

MORSTATE

1.09

1.01

1.01

 PCV (% explained variance)

-

99 %

99 %

 Health Centre (variance (SE))

0.44 (0.08)

0.35 (0.07)

0.35 (0.07)

 

MORHC

1.88

1.76

1.75

 PCV (% explained variance)

-

20 %

21 %

 State & Health Centre (variance (SE))

0.44

0.35

0.35

 

MORSTATE-HC

1.89

1.76

1.75

 PCV (% explained variance)

-

20 %

22 %

 

Patient (variance (SE))

1.11 (0.16)

1.13 (0.27)

0.97 (0.35)

  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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