Table 5.
Adjusted multilevel logistic regression models of health centre and client level factors associated with top quartile delivery of guideline-scheduled laboratory tests (N = 15,622 clients, 162 health centres)
| 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 | 0.86 (0.71–1.05) | 0.77 (0.62–0.95)* | 0.80 (0.65–0.99)* | |
| 2008 | 0.87 (0.72–1.04) | 0.76 (0.61–0.93)** | 0.80 (0.65–0.99)* | |
| 2009 | 1.08 (0.90–1.29) | 0.92 (0.74–1.14) | 0.94 (0.75–1.17) | |
| 2010 | 1.23 (1.02–1.49)* | 1.03 (0.82–1.30) | 1.03 (0.82–1.30) | |
| 2011 | 0.81 (0.69–0.97)** | 0.73 (0.58–0.92)** | 0.72 (0.57–0.91)** | |
| 2012 | 1.26 (1.05–1.50)* | 1.01 (0.77–1.32) | 0.99 (0.75–1.29) | |
| 2013 | 1.67 (1.40–2.00)** | 1.28 (0.96–1.70) | 1.22 (0.92–1.63) | |
| 2014 | 1.82 (1.45–2.28)** | 1.49 (1.08–2.06)* | 1.44 (1.04–1.99)* | |
| Health Centre Characteristics | ||||
| Location X duration of CQI participation | ||||
| Non-remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 1.03 (0.82–1.28) | 0.99 (0.79–1.23) | ||
| ≥3 cycles | 0.91 (0.66–1.26) | 0.87 (0.63–1.21) | ||
| Remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 4.43 (3.06–6.41)** | 4.59 (3.17–6.63)** | ||
| ≥3 cycles | 4.68 (3.07–7.14)** | 4.84 (3.18–7.37)** | ||
| Governance | Community-Controlled | 1.00 (reference) | 1.00 (reference) | |
| Government operated | 0.76 (0.53–1.08) | 0.78 (0.55–1.11) | ||
| Service population | ≤500 | 1.00 (reference) | 1.00 (reference) | |
| >500- < 1000 | 1.24 (0.88–1.76) | 1.23 (0.87–1.73) | ||
| ≥1000 | 1.16 (0.84–1.61) | 1.17 (0.84–1.61) | ||
| % Clients attending in past 6 months | <97 % | 1.00 (reference) | 1.00 (reference) | |
| ≥97 % | 1.39 (1.26–1.54)** | 1.38 (1.25–1.53)** | ||
| Client Characteristics | ||||
| Sex | Male | 1.00 (reference) | ||
| Female | 1.06 (0.99–1.14) | |||
| Age | ≥15- < 25 | 1.00 (reference) | ||
| ≥25- < 40 | 1.12 (0.85–1.47) | |||
| ≥40- < 55 | 1.27 (0.97–1.67) | |||
| ≥55 | 1.39 (1.06–1.82)* | |||
| Indigenous Status | Non-Indigenous | 1.00 (reference) | ||
| Indigenous | 1.07 (0.91–1.26) | |||
| Comorbidity | None | 1.00 (reference) | ||
| One or more | 1.38 (1.27–1.51)** | |||
| Complications | None | 1.00 (reference) | ||
| 1–2 complications | 1.18 (1.06–1.32)** | |||
| >2 complications | 1.24 (1.03–1.48)* | |||
| Random effects (intercepts) | ||||
| State (variance (SE)) | 0.51 (0.37) | 0.16 (0.13) | 0.15 (0.12) | |
| MORSTATE | 1.97 | 1.46 | 1.44 | |
| PCV (% explained variance) | - | 70 % | 72 % | |
| Health Centre (variance (SE)) | 0.96 (0.14) | 0.56 (0.09) | 0.55 (0.09) | |
| MORHC | 2.55 | 2.04 | 2.02 | |
| PCV (% explained variance) | - | 42 % | 43 % | |
| State & Health Centre (variance) | 1.470 | 0.717 | 0.692 | |
| MORSTATE-HC | 3.18 | 2.24 | 2.21 | |
| PCV (% explained variance) | - | 52 % | 53 % | |
| Patient (variance (SE)) | 0.39 (0.14) | 0.19 (0.06) | 0.11 (0.03) | |
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
*p < 0.05
**p = <0.01