Table 4.
Odds of being at controlled at index and odds of being controlled at index or receiving appropriate follow-up care within 90 for at least 1, at least 2, or all 3 quality indicatorsa for each definition of clinical complexity
| Odds Ratio (95% CI)b | ||||||
|---|---|---|---|---|---|---|
|
| ||||||
| Controlled at index | Controlled at index or received appropriate follow-up carec | |||||
|
| ||||||
| Clinical Complexity Definition | For at Least 1 Quality Indicator vs. 0 | For at Least 2 Quality Indicators vs. 0 or 1 | For all 3 Quality Indicators vs. 0, 1, or 2 | For at Least 1 Quality Indicator vs. 0 | For at Least 2 Quality Indicators vs. 0 or 1 | For all 3 Quality Indicators vs. 0, 1, or 2 |
| Number of Comorbidities | ||||||
|
| ||||||
| 0 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
|
| ||||||
| 1 | 1.97 (1.74–2.23) | 1.72 (1.55–1.91) | 1.53 (1.30–1.79) | 2.31 (1.90–2.80) | 1.81 (1.62–2.03) | 1.53 (1.37–1.70) |
|
| ||||||
| 2 | 2.16 (1.93–2.43) | 1.84 (1.67–2.03) | 1.56 (1.34–1.81) | 3.49 (2.90–4.19) | 2.44 (2.20–2.71) | 1.81 (1.63–2.00) |
|
| ||||||
| ≥3 | 2.71 (2.40–3.06) | 2.27 (2.05–2.50) | 1.94 (1.67–2.26) | 6.73 (5.38–8.41) | 3.49 (3.12–3.90) | 2.30 (2.07–2.54) |
|
| ||||||
| Illness Severity (DCG RRS) | ||||||
| <0.50 | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
|
| ||||||
| 0.50–0.99 | 1.16 (1.06–1.28) | 1.13 (1.06–1.20) | 1.12 (1.04–1.22) | 1.30 (1.08–1.57) | 1.20 (1.11–1.31) | 1.10 (1.04–1.17) |
|
| ||||||
| 1.00–1.99 | 1.11 (1.01–1.22) | 1.09 (1.03–1.16) | 1.11 (1.02–1.20) | 1.36 (1.12–1.65) | 1.20 (1.10–1.31) | 1.12 (1.05–1.19) |
|
| ||||||
| ≥2.00 | 1.13 (1.03–1.25) | 1.19 (1.12–1.26) | 1.22 (1.13–1.32) | 1.38 (1.14–1.67) | 1.22 (1.12–1.33) | 1.25 (1.18–1.33) |
Abbreviations: DCG RRS, Diagnostic Cost Group Relative Risk Score
a
Diabetes quality indicators assessed included: blood pressure <130/80 mm Hg, hemoglobin A1c <7.0%, and low-density lipoprotein cholesterol <100 mg/dL.
b
Each model is adjusted for age, number of primary and specialty care visits to the VA in the prior year, and clustering of patients at facilities.
c
Appropriate follow-up care includes medication treatment intensification or a controlled reading during the 90-day follow-up period