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Table 5 Parameter estimates for Model 6 (full model) for the nine low-value procedures

From: Exploring variation in low-value care: a multilevel modelling study

Variable Statistic Sentinel lymph node biopsy Carotid endarterectomy EVAR Knee arthroscopy ERCP Abdominal hysterectomy Spinal fusion Colonoscopy Endoscopy
Episode level
 Age group*
  1 OR 18–39: 0.2 18–74: 0.8 18–74: 0.5 54–64: 2.1 18–39: 0.5 18–39: 0.7 18–49: 0.5 18–29: 0.6 18–24: 0.4
  (0.1–0.5) (0.5–1.2) (0.3–0.7) (1.9–2.2) (0.3–0.7) (0.7–0.8) (0.3–0.7) (0.5–0.7) (0.3–0.4)
  2 OR 40–54: 0.9 75–79: 1 75–79: 1 65–79: 1 40–54: 0.6 40–49: 1 50–64: 1 30–34: 0.6 25–34: 0.5
  (0.6–1.3)     (0.4–0.8)    (0.5–0.7) (0.5–0.5)
  3 OR 55–69: 1 80–84: 0.8 80–84: 1.5 70–79: 0.5 55–69: 1 50–59: 0.8 65–79: 1.0 35–44: 0.9 35–44: 0.7
   (0.6–1.1) (1.0–1.2) (0.5–0.6)   (0.7–0.8) (0.7–1.5) (0.8–1.0) (0.7–0.8)
  4 OR 70–100: 0.8 85–99: 0.8 85–99: 0.9 80–110: 0.2 70–105: 1.9 60–95: 0.2 80–105: 0.1 45–49: 1 45–54: 1
  (0.6–1.1) (0.5–1.2) (0.6–1.4) (0.1–0.2) (1.4–2.6) (0.2–0.3) (0.1–0.3)   
 Female OR 0.6 1.0 0.7 0.9 1.0   1.0 1.4 1.0
  (0.4–0.8) (0.7–1.3) (0.5–1.0) (0.8–1.0) (0.8–1.2)   (0.8–1.5) (1.3–1.6) (0.9–1.0)
 Charlson comorbidity index
  1 OR 1.2 0.5 0.9 0.7 0.7 1.1 0.7 0.4 0.5
  (0.7–2.0) (0.3–0.7) (0.6–1.3) (0.6–0.7) (0.5–1.1) (0.9–1.3) (0.4–1.1) (0.3–0.5) (0.5–0.6)
  2–16 OR 0.8 0.3 0.8 0.2 1.0 1.8 0.2 0.3 0.2
  (0.4–1.8) (0.2–0.4) (0.6–1.1) (0.2–0.3) (0.7–1.4) (1.3–2.4) (0.1–0.3) (0.2–0.4) (0.2–0.3)
 Private patient OR 1.8 1.2 1.0 0.5 2.4 1.2 0.2 0.6 0.6
  (1.1–2.8) (0.8–1.7) (0.6–1.5) (0.4–0.6) (1.8–3.1) (1.0–1.4) (0.1–0.4) (0.5–0.7) (0.6–0.7)
 Financial year OR 1.1 1.1 1.1 0.9 1.0 0.9 1.0 1.0 1.0
  (1.0–1.2) (1.0–1.2) (1.0–1.1) (0.9–0.9) (0.9–1.0) (0.9–1.0) (0.9–1.1) (0.9–1.0) (1.0–1.0)
Hospital level
 Peer group
  B OR 0.4 2.5 1.0 1.1 0.6 0.8 0.4 1.1 1.2
  (0.1–1.6) (1.0–6.9) (0.4–3.3) (0.8–1.4) (0.4–0.9) (0.5–1.2) (0.0–4.0) (0.7–1.6) (0.8–1.8)
  IOR80 0.1–2.7 0.6–11 0.5–2.2 0.1–13 0.4–0.9 0.2–2.6 0.1–3.5 0.4–3.0 0.4–4.0
  C1 OR 0.4    2.2   1.2   1.2 0.7
  (0.1–1.9)    (0.9–5.1)   (0.6–2.1)   (0.7–2.0) (0.4–1.1)
  IOR80 0.1–2.5    0.2–28   0.4–3.9   0.4–3.3 0.2–2.3
  C2 OR 0.2    4.2   0.6   0.9 0.9
  (0.0–1.2)    (1.7–9.6)   (0.3–1.0)   (0.5–1.6) (0.6–1.5)
  IOR80 0.0–1.1    0.3–52   0.2–1.8   0.3–2.6 0.3–3.0
  D1a OR     3.6     1.3 0.6
     (0.9–13)     (0.5–2.9) (0.3–1.2)
  IOR80     0.3–45     0.5–3.5 0.2–2.0
  D1b OR         0.9 0.6
         (0.2–3.3) (0.2–1.8)
  IOR80         0.3–2.5 0.2–1.8
  Procedure as proportion total volume OR 1.3 4.2 3.4 1.1 4.5 1.0 1.2 1.1 1.1
  (1.1–1.5) (2.0–11.4) (1.4–7.9) (1.1–1.1) (2.6–7.8) (0.9–1.0) (0.8–1.8) (1.1–1.1) (1.1–1.1)
  IOR80 0.2–8.5 1.0–19 1.6–7.2 0.1–14 2.9–7.1 0.3–3.3 0.1–11 0.4–3.0 0.3–3.6
  Variance 1.1 0.7 0.2 2.0 0.1 0.4 1.5 0.3 0.4
(0.4–2.4) (0.3–1.4) (0.0–0.5) (1.4–2.8) (0.0–0.2) (0.3–0.7) (0.5–3.8) (0.2–0.5) (0.3–0.6)
  VPC 20 16 4.7 35 1.8 11 29 8.3 11
  MOR 2.7 (1.8–4.3) 2.2 (1.6–3.1) 1.5 (1.2–1.9) 3.8 (3.0–5.0) 1.3 (1.1–1.6) 1.9 (1.7–2.2) 3.2 (2.0–6.5) 1.7 (1.5–2.0) 1.9 (1.7–2.1)
 LHD level
  Rural OR 1.5 1.0 1.1 2.1 1.0 1.0 0.2 1.4 1.3
  (0.4–7.3) (0.3–4.3) (0.4–2.8) (0.7–6.2) (0.5–1.9) (0.6–1.9) (0.0–2.0) (0.9–2.3) (0.7–2.2)
  IOR80 0.3–7.6 0.6–1.9   0.8–5.7 0.6–1.5 0.6–1.8   0.9–2.2 0.7–2.4
Variance 0.8 0.1   0.3 0.1 0.1   0.1 0.1
(0.0–2.7) (0.0–0.8)   (0.0–1.1) (0.0–0.3) (0.0–0.4)   (0.0–0.2) (0.0–0.4)
VPC 14 2.8   5.2 1.9 2.8   1.6 2.9
MOR 2.3 (1.2–4.3) 1.4 (1.0–2.3)   1.7 (1.1–2.7) 1.3 (1.0–1.7) 1.4 (1.1–1.8)   1.3 (1.0–1.6) 1.4 (1.1–1.8)
SLA level
 IRSAD quintile
  2 OR 0.6 1.1 0.8 1.2 1.0 1.0 0.7 1.0 0.9
  (0.3–1.1) (0.7–1.7) (0.5–1.3) (1.0–1.4) (0.7–1.5) (0.9–1.1) (0.4–1.3) (0.7–1.3) (0.8–1.1)
  IOR80 0.2–1.8 0.6–2.0 0.5–1.2 0.7–2.0 0.6–1.6 0.8–1.2 0.2–2.1 0.5–2.0 0.5–1.8
  3 OR 0.9 1.2 1.1 1.2 0.9 0.9 0.4 1.2 1.0
   (0.4–1.6) (0.7–2.1) (0.7–2.1) (0.9–1.4) (0.5–1.5) (0.8–1.1) (0.2–0.9) (0.8–1.6) (0.8–1.2)
  IOR80 0.3–2.5 0.6–2.2 0.7–1.8 0.7–2.0 0.5–1.5 0.8–1.1 0.1–1.2 0.6–2.4 0.5–1.8
  4 OR 1.0 1.4 0.6 1.2 1.2 1.0 0.4 1.0 0.9
  (0.5–2.0) (0.8–2.5) (0.4–1.1) (0.9–1.5) (0.7–1.9) (0.8–1.2) (0.2–0.9) (0.7–1.4) (0.7–1.2)
  IOR80 0.3–2.8 0.7–2.6 0.4–1.0 0.7–2.0 0.7–1.9 0.8–1.2 0.1–1.3 0.5–2.0 0.5–1.7
  5 OR 0.7 1.3 1.0 1.3 1.4 1.0 0.6 0.9 0.9
  (0.3–1.4) (0.7–2.5) (0.5–1.9) (1.0–1.7) (0.8–2.4) (0.8–1.2) (0.2–1.3) (0.6–1.3) (0.7–1.2)
  IOR80 0.2–1.9 0.7–2.4 0.6–1.6 0.8–2.2 0.8–2.2 0.8–1.2 0.2–1.8 0.4–1.9 0.5–1.6
 Remoteness category
  Inner Regional OR 2.5 0.6 0.9 0.7 1.5 1.1 3.8 1.0 1.3
  (1.4–4.7) (0.4–1.0) (0.5–1.4) (0.6–0.9) (0.9–2.5) (0.9–1.3) (2.0–6.7) (0.8–1.4) (1.0–1.6)
  IOR80 0.9–7.1 0.3–1.1 0.5–1.4 0.4–1.2 0.9–2.4 0.9–1.3 1.2–12 0.5–2.2 0.7–2.3
  Outer Regional OR 2.9 0.7 1.8 0.7 1.9 1.2 2.9 1.6 1.7
(1.1–6.9) (0.4–1.4) (0.8–4.4) (0.5–0.9) (1.0–4.2) (1.0–1.6) (0.9–7.5) (1.1–2.4) (1.2–2.4)
  IOR80 1.0–8.4 0.4–1.3 1.1–2.9 0.4–1.2 1.2–3.2 1.0–1.5 0.9–9.1 0.8–3.3 0.9–3.1
  Remote/Very remote OR     0.6   1.0 3.3 0.9 1.6
     (0.3–1.3)   (0.6–1.6) (0.2–30) (0.3–2.4) (0.8–3.0)
  IOR80     0.4–1.1   0.8–1.2 1.1–10.5 0.4–1.8 0.8–2.9
  Population prevalence of indication OR 1.1 1.3 0.9 1.0 1.1   0.7 0.9 0.9
  (0.3–4.4) (0.5–3.0) (0.4–1.9) (0.9–1.1) (0.9–1.3)   (0.5–1.1) (0.9–1.0) (0.8–1.0)
  IOR80 0.4–3.3 0.7–2.4 0.5–1.4 0.6–1.7 0.7–1.7   0.2–2.3 0.4–1.9 0.5–1.7
Variance 0.3 0.1 0.1 0.1 0.1 0.0 0.4 0.2 0.1
(0.1–0.8) (0.0–0.3) (0.0–0.3) (0.1–0.1) (0.0–0.2) (0.0–0.0) (0.1–0.8) (0.1–0.2) (0.1–0.2)
VPC 6.2 2.8 2.0 1.5 2.1 0.3 7.7 4.3 2.9
MOR 1.7 (1.3–2.3) 1.4 (1.1–1.7) 1.3 (1.0–1.6) 1.3 (1.3–1.4) 1.3 (1.0–1.6) 1.1 (1.0–1.2) 1.8 (1.4–2.4) 1.5 (1.4–1.6) 1.4 (1.3–1.5)
  1. *Age groups differ between services and are set at approximate quartiles for the cohort for each service. Individual age groups are specified before the parameter estimates. Reference categories were selected according to what seemed most appropriate for each procedure
  2. ERCP endoscopic retrograde cholangiopancreatography, EVAR endovascular repair of abdominal aortic aneurysm, IOR80 80% interval odds ratio, IRSAD Index of Relative Socioeconomic Advantage and Disadvantage, LHD Local Health District, MOR median odds ratio, OR odds ratio, SLA Statistical Local Area, VPC variance partition coefficient