Table 8.
Adjusted multilevel logistic regression models of health centre and client level factors associated with top quartile delivery of guideline-scheduled counselling or education (for nutrition and physical activity) (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 | 1.68 (1.38–2.04)** | 1.27 (1.03–1.57)* | 1.33 (1.08–1.64)** | |
| 2008 | 1.69 (1.41–2.01)** | 1.36 (1.11–1.68)** | 1.46 (1.18–1.80)** | |
| 2009 | 2.69 (2.24–3.23)** | 2.20 (1.76–2.74)** | 2.26 (1.81–2.82)** | |
| 2010 | 2.69 (2.22–3.26)** | 2.37 (1.82–3.00)** | 2.40 (1.89–3.03)** | |
| 2011 | 2.14 (1.80–2.54)** | 2.06 (1.62–2.61)** | 2.06 (1.62–2.61)** | |
| 2012 | 2.18 (1.83–2.59)** | 1.67 (1.27–2.18)** | 1.64 (1.26–2.15)** | |
| 2013 | 2.43 (2.86–4.12)** | 2.58 (1.93–3.44)** | 2.52 (1.89–3.36)** | |
| 2014 | 2.48 (1.98–3.12)** | 2.13 (1.54–2.96)** | 2.10 (1.51–2.91)** | |
| Health Centre Characteristics | ||||
| Location X duration of CQI participation | ||||
| Non-remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 2.09 (1.72–2.53)** | 2.04 (1.68–2.47)** | ||
| ≥3 cycles | 0.92 (0.68–1.25) | 0.90 (0.66–1.22) | ||
| Remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 1.27 (0.84–1.91) | 1.31 (0.91–1.87) | ||
| ≥3 cycles | 2.41 (1.54–3.79)** | 2.47 (1.64–3.74)** | ||
| Governance | Community-Controlled | 1.00 (reference) | 1.00 (reference) | |
| Government operated | 0.85 (0.59–1.20) | 0.87 (0.62–1.22) | ||
| Service population | ≤500 | 1.00 (reference) | 1.00 (reference) | |
| 501–999 | 0.96 (0.66–1.41) | 0.95 (0.65–1.39) | ||
| ≥1000 | 0.80 (0.56–1.14) | 0.81 (0.57–1.14) | ||
| % Clients attending in past 6 months | <97 % | 1.00 (reference) | 1.00 (reference) | |
| ≥97 % | 1.30 (1.17–1.44)** | 1.29 (1.16–1.44)** | ||
| Client Characteristics | ||||
| Sex | Male | 1.00 (reference) | ||
| Female | 1.02 (0.95–1.09) | |||
| Age | ≥15- < 25 | 1.00 (reference) | ||
| ≥25- < 40 | 1.29 (0.99–1.70) | |||
| ≥40- < 55 | 1.41 (1.08–1.85)* | |||
| ≥55 | 1.36 (1.04–1.78)* | |||
| Indigenous Status | Non-Indigenous | 1.00 (reference) | ||
| Indigenous | 0.97 (0.83–1.14) | |||
| Comorbidity | None | 1.00 (reference) | ||
| One or more | 1.38 (1.27–1.51)** | |||
| Complications | No complications | 1.00 (reference) | ||
| 1–2 complications | 1.17 (1.05–1.31)** | |||
| >2 complications | 1.03 (0.86–1.24) | |||
| Random effects (intercepts) | ||||
| State (variance (SE)) | 0.12 (0.12) | 0.002 (0.02) | 0.0002 (0.005) | |
| MORSTATE | 1.38 | 1.04 | 1.01 | |
| PCV (% explained variance) | - | 98 % | 100 % | |
| Health Centre (variance (SE)) | 0.77 (0.11) | 0.69 (0.10) | 0.68 (0.09) | |
| MORHC | 2.31 | 2.21 | 2.20 | |
| PCV (% explained variance) | - | 10 % | 12 % | |
| State & Health Centre (variance) | 0.88 | 0.70 | 0.68 | |
| MORSTATE-HC | 2.45 | 2.22 | 2.20 | |
| PCV (% explained variance) | - | 21 % | 23 % | |
| Patient (variance (SE)) | 0.62 (0.12) | 0.47 (0.12) | 0.27 (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