Table 2.
Relationship between lupus disease activity and quality of care, with and without adjustment for disease status, health services and sociodemographic characteristics.
| Characteristic | Increase in SLAQ by 4 or more points‡ (≥ 0.5 standard deviation) | |||||||
|---|---|---|---|---|---|---|---|---|
| Bivariable Results | Multivariable Results | |||||||
| Year-to-year | First-last | Year-to-year | First-last | |||||
| OR (95% CI) | OR (95% CI) | OR (95% CI) | OR (95% CI) | |||||
| High quality care (at least 85% of QMs met) | 1.0 (0.8, 1.3) | 1.0 (0.6, 1.6) | 0.9 (0.7, 1.2) | 0.9 (0.5, 1.4) | ||||
| Number of quality measures eligible for in baseline year | ||||||||
| 2-3 | ref | ref | ref | ref | ||||
| 4-6 | 1.0 (0.8, 1.3) | 1.1 (0.7, 1.7) | 1.1 (0.8, 1.4) | 1.2 (0.8, 1.9) | ||||
| 7-11 | 1.4 (1.03, 1.8) | * | 1.2 (0.8, 2.0) | 1.5 (1.1, 2.2) | * | 1.6 (0.9, 2.9) | ||
| Number of visits in baseline year (1-41) | 1.01 (1.0, 1.0) | * | 1.0 (1.0, 1.0) | 1.02 (1.0, 1.0) | * | 1.0 (1.0, 1.0) | ||
| Baseline BILD score | 1.1 (1.0, 1.1) | * | 1.1 (1.0, 1.2) | * | 1.1 (1.0, 1.2) | * | 1.2 (1.1, 1.3) | * |
| Baseline SLAQ score | 1.0 (1.0, 1.0) | 1.0 (0.9, 1.0) | * | 0.9 (0.9, 1.0) | * | 0.9 (0.9, 1.0) | * | |
| Disease duration, per 10 years | 1.0 (0.9, 1.1) | 1.1 (0.9, 1.3) | 1.0 (1.0, 1.0) | 0.9 (0.7, 1.1) | ||||
| Male | 1.0 (0.7, 1.5) | 1.3 (0.6, 2.7) | 1.1 (0.7, 1.7) | 1.7 (0.8, 3.6) | ||||
| Age, per 10 years | 1.1 (1.0, 1.2) | * | 1.0 (0.9, 1.2) | 1.1 (1.0, 1.2) | * | 1.1 (0.9, 1.3) | ||
| Nonwhite race or Hispanic ethnicity | 1.0 (0.8, 1.3) | 1.0 (0.7, 1.4) | 1.0 (0.8, 1.3) | 0.9 (0.6, 1.3) | ||||
| Education | ||||||||
| High school or less | 1.6 (1.2, 2.1) | * | 1.5 (0.9, 2.5) | 1.6 (1.2, 2.3) | * | 1.8 (1.0, 3.0) | * | |
| Some post secondary, no BA/BS | 1.8 (1.4, 2.2) | * | 1.5 (1.0, 2.3) | * | 1.8 (1.4, 2.3) | * | 1.8 (1.2, 2.7) | * |
| Bachelors degree or beyond | ref | ref | ref | ref | ||||
| Health Insurance Source and Type† | ||||||||
| Private | 0.8 (0.6, 1.0) | 0.9 (0.7, 1.3) | 0.9 (0.7, 1.2) | 1.1 (0.7, 1.6) | ||||
| Enrolled in HMO | 1.1 (0.9, 1.4) | 1.2 (0.9, 1.8) | 1.2 (1.0, 1.6) | 1.4 (0.9, 2.1) | ||||
| Saw rheumatologist in baseline year | 1.2 (0.9, 1.5) | 0.8 (0.5, 1.2) | 1.1 (0.8, 1.5) | 0.8 (0.5, 1.3) | ||||
| Saw generalist in baseline year | 1.8 (1.3, 2.5) | * | 1.0 (0.6, 1.5) | 1.9 (1.3, 2.7) | * | 1.0 (0.6, 1.7) | ||
An increase of ≥ 0.5 standard deviation in the SLAQ score was observed in 155 of 737 participants (21%), and in 405 of 2,251 observations (18%).
p<0.05
SLAQ=systemic lupus activity questionnaire, QM=quality measure, BILD=brief index of lupus damage, HMO=health maintenance organization.
Multivariable models control for all variables above, as well as time between baseline and follow-up interviews.
For annual change in SLAQ, generalized estimating equation (GEE) methods were used to account for repeated measures.
Uninsured (22 participants, 53 observations) included in referent categories for both variables.