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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