Table 3.
Patient and physician level predictors of alert generation
| Number of visits=8931 | Descriptive statistics |
Multivariate logistic regression analysis* |
|||||
|---|---|---|---|---|---|---|---|
| No alert (n=3863) |
Alert (n=5068) |
OR | 95% CI | p Value | |||
| Patient | |||||||
| Demographic characteristics | n | % | n | % | |||
| Female | 2730 | 70.7 | 3547 | 70 | 0.85 | 0.75 to 0.98 | 0.02 |
| Male | 1133 | 29.3 | 1521 | 30 | Reference | Reference | Reference |
| Mean | SD | Mean | SD | ||||
| Age (per year) | 75.7 | 6.5 | 75.9 | 6.6 | 0.99 | 0.98 to 1 | 0.17 |
| Risk factors for fall-related injuries | n | % | n | % | |||
| Fall-related injury | 302 | 7.8 | 580 | 11.4 | 1.44 | 1.03 to 2.01 | 0.04 |
| Gait and balance problems | 938 | 24.3 | 1447 | 28.6 | 1.15 | 0.99 to 1.33 | 0.06 |
| Lower-extremity weakness | 317 | 8.2 | 435 | 8.6 | 0.95 | 0.75 to 1.21 | 0.68 |
| Cognitive impairment | 193 | 5 | 208 | 4.1 | 0.91 | 0.64 to 1.29 | 0.59 |
| Mean | SD | Mean | SD | ||||
| Number of ambulatory care visits (year prior to visit) (OR per 5 visit increase) | 11.2 | 7.7 | 12.9 | 10 | 1.08 | 1.05 to 1.12 | <0.01 |
| Number of active medications (at visit) | 8.3 | 3.8 | 10.3 | 4.4 | 1.12 | 1.10 to 1.14 | <0.01 |
| Physician | |||||||
| Demographic characteristics | n | % | n | % | |||
| Female | 1411 | 36.5 | 1462 | 28.8 | 0.61 | 0.42 to 0.91 | 0.01 |
| Male | 2452 | 63.5 | 3606 | 71.2 | Reference | Reference | Reference |
| Mean | SD | Mean | SD | ||||
| Practice experience (OR per 5 year increase) | 26.2 | 5.4 | 26.5 | 5.7 | 0.89 | 0.76 to 1.03 | 0.12 |
| Practice characteristics | |||||||
| Daily practice volume (OR per 5 patient increase) | 23.1 | 6.7 | 21.7 | 7 | 0.89 | 0.79 to 0.99 | 0.03 |
| Percent of patients 65 years and older (OR per 10% increase) | 25.7 | 10.8 | 25.5 | 11.4 | 1 | 0.89 to 1.11 | 0.96 |
| Experience and skills related to electronic prescribing | |||||||
| Electronic prescription speed (minutes per 3 e-RXs) (per minute increase) | 5.3 | 1.6 | 5.6 | 1.6 | 1.01 | 0.93 to 1.10 | 0.78 |
| Electronic prescription rate (e-RXs per 100 visits) (OR per 10 e-RX increase) | 25.7 | 13 | 27.6 | 12.3 | 1.06 | 0.96 to 1.17 | 0.28 |
| Alert level setting | |||||||
| View severe alerts only | 3143 | 41 | 4527 | 59 | 1.99 | 1.04 to 3.81 | 0.04 |
| View serious and severe alerts only, or view all alerts | 885 | 44.9 | 1085 | 55.1 | Reference | Reference | Reference |
*The dataset comprised 8931 visits clustered within 3413 patients clustered within 61 physicians. Alternating logistic regression was used to account for clustering (visits within patients and patients within providers).