Table 9.
Adjusted multilevel logistic regression models of health centre and client level factors associated with top quartile delivery of guideline-scheduled counselling or education (for smoking and alcohol risk reduction amongst high risk users) (N = 5496 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 | 3.30 (2.23–4.88)** | 2.67 (1.77–4.03)** | 2.80 (1.85–4.22)** | |
| 2008 | 2.32 (1.67–3.21)** | 1.87 (1.31–2.67)** | 1.96 (1.37–2.81)** | |
| 2009 | 2.33 (1.71–3.18)** | 1.90 (1.34–2.69)** | 1.96 (1.38–2.78)** | |
| 2010 | 2.21 (1.59–3.09)** | 1.88 (1.30–2.74)** | 1.90 (1.31–2.76)** | |
| 2011 | 2.25 (1.66–3.05)** | 1.99 (1.41–2.82)** | 2.01 (1.42–2.85)** | |
| 2012 | 2.25 (1.67–3.02)** | 1.74 (1.19–2.54)** | 1.75 (1.20–2.56)** | |
| 2013 | 2.76 (2.03–3.76)** | 2.06 (1.39–3.06)** | 2.07 (1.40–3.07)** | |
| 2014 | 2.41 (1.67–3.45)** | 1.81 (1.15–2.86)* | 1.82 (1.16–2.88)** | |
| Health Centre Characteristics | ||||
| Location X duration of CQI participation | ||||
| Non-remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 1.83 (1.29–2.59)** | 1.78 (1.26–2.53)** | ||
| ≥3 cycles | 1.71 (1.01–2.89)* | 1.64 (0.97–2.77) | ||
| Remote | Baseline | 1.00 (reference) | 1.00 (reference) | |
| 1–2 cycles | 0.94 (0.65–1.35) | 0.93 (0.65–1.35) | ||
| ≥3 cycles | 1.03 (0.61–1.75) | 1.04 (0.62–1.76) | ||
| Governance | Community-Controlled | 1.00 (reference) | 1.00 (reference) | |
| Government operated | 0.67 (0.50–0.91)* | 0.69 (0.51–0.94)* | ||
| Service population | ≤500 | 1.00 (reference) | 1.00 (reference) | |
| 501–999 | 0.92 (0.67–1.27) | 0.92 (0.66–1.27) | ||
| ≥1000 | 0.99 (0.74–1.34) | 1.00 (0.74–1.35) | ||
| % Clients attending in past 6 months | <97 % | 1.00 (reference) | 1.00 (reference) | |
| ≥97 % | 1.06 (0.90–1.26) | 1.05 (0.88–1.24) | ||
| Client Characteristics | ||||
| Sex | Male | 1.00 (reference) | ||
| Female | 1.00 (0.88–1.13) | |||
| Age | ≥15- < 25 | 1.00 (reference) | ||
| ≥25- < 40 | 0.90 (0.57–1.42) | |||
| ≥40- < 55 | 0.97 (0.62–1.53) | |||
| ≥55 | 0.92 (0.58–1.45) | |||
| Indigenous Status | Non-Indigenous | 1.00 (reference) | ||
| Indigenous | 1.07 (0.76–1.51) | |||
| Comorbidity | None | 1.00 (reference) | ||
| One or more | 1.23 (1.06–1.43)** | |||
| Disease severity | No complications | 1.00 (reference) | ||
| 1–2 complications | 1.10 (0.90–1.35) | |||
| >2 complications | 1.17 (0.84–1.64) | |||
| Random effects (intercepts) | ||||
| State (variance (SE)) | 0.01 (0.02) | 0.00007 (0.001) | 0.00008 (0.001) | |
| MORSTATE | 1.09 | 1.01 | 1.01 | |
| PCV (% explained variance) | - | 99 % | 99 % | |
| Health Centre (variance (SE)) | 0.44 (0.08) | 0.35 (0.07) | 0.35 (0.07) | |
| MORHC | 1.88 | 1.76 | 1.75 | |
| PCV (% explained variance) | - | 20 % | 21 % | |
| State & Health Centre (variance (SE)) | 0.44 | 0.35 | 0.35 | |
| MORSTATE-HC | 1.89 | 1.76 | 1.75 | |
| PCV (% explained variance) | - | 20 % | 22 % | |
| Patient (variance (SE)) | 1.11 (0.16) | 1.13 (0.27) | 0.97 (0.35) | |
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