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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