Table 7.
Adjusted multilevel logistic regression models of health centre and client level factors associated with top quartile delivery of guideline-scheduled specialist 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 | 0.88 (0.72–1.08) | 0.74 (0.60–0.91)** | 0.75 (0.60–0.93)** | |
| 2008 | 0.95 (0.80–1.13) | 0.78 (0.63–0.96)* | 0.83 (0.67–1.03) | |
| 2009 | 1.26 (1.04–1.51)* | 1.02 (0.82–1.27) | 1.05 (0.84–1.32) | |
| 2010 | 1.06 (0.87–1.29) | 0.86 (0.68–1.09) | 0.86 (0.68–1.10) | |
| 2011 | 1.02 (0.85–1.21) | 0.87 (0.69–1.10) | 0.86 (0.67–1.09) | |
| 2012 | 1.29 (1.08–1.53)* | 0.95 (0.73–1.24) | 0.95 (0.72–1.25) | |
| 2013 | 1.64 (1.36–1.97)** | 1.16 (0.87–1.54) | 1.09 (0.82–1.46) | |
| 2014 | 1.65 (1.30–2.08)** | 1.21 (0.87–1.68) | 1.13 (0.81–1.57) | |
| Health Centre Characteristics | ||||
| Location X duration of CQI participation | ||||
| Non-remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 1.59 (1.32–1.91)** | 1.53 (1.26–1.84)** | ||
| ≥3 cycles | 1.26 (0.93–1.71) | 1.20 (0.88–1.65) | ||
| Remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 1.24 (0.91–1.68) | 1.36 (0.99–1.85) | ||
| ≥3 cycles | 1.55 (1.07–2.24)* | 1.70 (1.16–2.47)** | ||
| Governance | Community-Controlled | 1.00 (reference) | 1.00 (reference) | |
| Government operated | 0.89 (0.66–1.20) | 0.93 (0.68–1.26) | ||
| Service population | ≤500 | 1.00 (reference) | 1.00 (reference) | |
| 501–999 | 0.94 (0.70–1.26) | 0.94 (0.70–1.27) | ||
| ≥1000 | 0.86 (0.65–1.12) | 0.86 (0.65–1.14) | ||
| % Clients attending in past 6 months | <97 % | 1.00 (reference) | 1.00 (reference) | |
| ≥97 % | 1.47 (1.32–1.64)** | 1.46 (1.31–1.62)** | ||
| Client Characteristics | ||||
| Sex | Male | 1.00 (reference) | ||
| Female | 1.14 (1.06–1.23)** | |||
| Age | ≥15- < 25 | 1.00 (reference) | ||
| ≥25- < 40 | 1.40 (1.07–1.83)* | |||
| ≥40- < 55 | 1.92 (1.48–2.51)** | |||
| ≥55 | 2.66 (2.04–3.47)** | |||
| Indigenous Status | Non-Indigenous | 1.00 (reference) | ||
| Indigenous | 1.23 (1.05–1.45)* | |||
| Comorbidity | None | 1.00 (reference) | ||
| One or more | 1.35 (1.24–1.47)** | |||
| Disease severity | No complications | 1.00 (reference) | ||
| 1–2 complications | 2.34 (2.06–2.67)** | |||
| >2 complications | 3.08 (2.45–3.88)** | |||
| Random effects (intercepts) | ||||
| State (variance (SE)) | 0.36 (0.26) | 0.18 (0.14) | 0.18 (0.14) | |
| MORSTATE | 1.77 | 1.49 | 1.49 | |
| PCV (% explained variance) | - | 49 % | 51 % | |
| Health Centre (variance (SE)) | 0.49 (0.07) | 0.38 (0.06) | 0.40 (0.06) | |
| MORHC | 1.95 | 1.80 | 1.83 | |
| PCV (% explained variance) | - | 23 % | 19 % | |
| State & Health Centre (variance) | 0.85 | 0.56 | 0.57 | |
| MORSTATE-HC | 2.41 | 2.03 | 2.06 | |
| PCV (% explained variance) | - | 34 % | 32 % | |
| Patient (variance (SE)) | 1.21 (0.35) | 1.00 (0.27) | 0.26 (0.08) | |
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