Table 6.
Adjusted multilevel logistic regression models of health centre and client level factors associated with top quartile delivery of guideline-scheduled generalist physical checks (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 | 2.45 (1.98–3.03)** | 1.75 (1.39–2.20)** | 1.82 (1.45–2.29)** | |
| 2008 | 3.20 (2.61–3.93)** | 1.97 (1.54–2.50)** | 2.10 (1.64–2.68)** | |
| 2009 | 5.09 (4.15–6.25)** | 2.96 (2.30–3.80)** | 3.05 (2.37–3.92)** | |
| 2010 | 5.11 (4.10–6.36)** | 2.87 (2.18–3.76)** | 2.89 (2.20–3.79)** | |
| 2011 | 5.12 (4.19–6.26)** | 2.99 (2.28–3.92)** | 2.99 (2.28–3.93)** | |
| 2012 | 6.56 (5.37–8.04)** | 2.86 (2.09–3.90)** | 2.86 (2.10–3.91)** | |
| 2013 | 9.77 (7.92–12.03)** | 3.86 (2.78–5.36)** | 3.81 (2.74–5.29)** | |
| 2014 | 9.57 (7.41–12.34)** | 3.86 (2.67–5.59)** | 3.79 (2.62–5.48)** | |
| Health Centre Characteristics | ||||
| Location X duration of CQI participation | ||||
| Non-remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 1.77 (1.40–2.24)** | 1.71 (1.35–2.17)** | ||
| ≥3 cycles | 2.13 (1.49–3.03)** | 2.02 (1.42–2.89)** | ||
| Remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 1.36 (0.90–2.05) | 1.35 (0.90–2.04) | ||
| ≥3 cycles | 1.35 (0.84–2.15) | 1.35 (0.85–2.16) | ||
| Governance | Community-Controlled | 1.00 (reference) | 1.00 (reference) | |
| Government operated | 0.73 (0.48–1.11) | 0.74 (0.49–1.13) | ||
| Service population | ≤500 | 1.00 (reference) | 1.00 (reference) | |
| 501–999 | 1.01 (0.67–1.52) | 1.01 (0.67–1.51) | ||
| ≥1000 | 0.72 (0.49–1.05) | 0.71 (0.49–1.04) | ||
| % Clients attending in past 6 months | <97 % | 1.00 (reference) | 1.00 (reference) | |
| ≥97 % | 1.39 (1.25–1.55)** | 1.38 (1.23–1.54)** | ||
| Client Characteristics | ||||
| Sex | Male | 1.00 (reference) | ||
| Female | 1.02 (0.95–1.10) | |||
| Age | ≥15- < 25 | 1.00 (reference) | ||
| ≥25- < 40 | 1.09 (0.81–1.47) | |||
| ≥40- < 55 | 1.43(1.06–1.92)* | |||
| ≥55 | 1.52 (1.13–2.05)** | |||
| Indigenous Status | Non-Indigenous | 1.00 (reference) | ||
| Indigenous | 1.27 (1.06–1.51)** | |||
| Comorbidity | None | 1.00 (reference) | ||
| One or more | 1.31 (1.19–1.44)** | |||
| Complications | No complications | 1.00 (reference) | ||
| 1–2 complications | 1.16 (1.03–1.30)* | |||
| >2 complications | 0.90 (0.74–1.09) | |||
| Random effects (intercepts) | ||||
| State (variance (SE)) | 0.80 (0.55) | 0.39 (0.28) | 0.39 (0.28) | |
| MORSTATE | 2.34 | 1.82 | 1.82 | |
| PCV (% explained variance) | - | 51 % | 51 % | |
| Health Centre (variance (SE)) | 0.90 (0.12) | 0.79 (0.11) | 0.78 (0.11) | |
| MORHC | 2.47 | 2.34 | 2.32 | |
| PCV (% explained variance) | - | 12 % | 14 % | |
| State & Health Centre (variance) | 1.70 | 1.19 | 1.17 | |
| MORSTATE-HC | 3.47 | 2.83 | 2.81 | |
| PCV (% explained variance) | - | 30 % | 31 % | |
| Patient (variance (SE)) | 0.11 (0.05) | 0.14 (0.05) | 0.07 (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