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Table 6 Adjusted multilevel logistic regression analysis of health centre and client level factors on composite indicator of recommended STI testing and counselling services for female clients (n = 137 health centres; 7,670 female patient records)

From: Wide variation in sexually transmitted infection testing and counselling at Aboriginal primary health care centres in Australia: analysis of longitudinal continuous quality improvement data

Outcome is 100% service delivery

Model A

Model B

Model C

Predictors

Fixed effects

OR

95% CI

OR

95% CI

OR

95% CI

Audit Year

2007

1.00

(reference)

1.00

(reference)

1.00

(reference)

2008

0.73

(0.45-1.18)

1.04

(0.63-1.74)

1.13

(0.66-1.91)

2009

0.70

(0.43-1.14)

0.87

(0.52-1.45)

0.88

(0.52-1.50)

2010

0.58

(0.35-0.95)

0.75

(0.44-1.29)

0.75

(0.43-1.30)

2011

0.44

(0.27-0.71)a

0.61

(0.36-1.03)

0.61

(0.36-1.05)

2012

0.61

(0.38-1.00)

0.69

(0.41-1.17)

0.70

(0.41-1.21)

2013

0.74

(0.45-1.20)

0.83

(0.49-1.42)

0.83

(0.48-1.45)

2014

0.51

(0.31-0.85)

0.55

(0.31-0.96)

0.49

(0.27-0.87)

Health Centre Characteristics

Location

Urban

  

1.00

(reference)

1.00

(reference)

Regional

  

0.34

(0.16-0.72)

0.34

(0.16-0.73)

Remote

  

1.05

(0.56-1.98)

1.10

(0.59-2.06)

Duration of participation in ABCD CQI project

Baseline

  

1.00

(reference)

1.00

(reference)

1-2 cycles

  

1.41

(1.16-1.70)b

1.47

(1.21-1.79)b

≥3 cycles

  

1.28

(0.99-1.67)

1.38

(1.05-1.80)

Provided adult health checka

No

  

1.00

(reference)

1.00

(reference)

Yes

  

2.11

(1.83-2.44)b

2.24

(1.93-2.60)b

Provided Pap smear

No

  

1.00

(reference)

1.00

(reference)

Yes

  

3.66

(3.24-4.14)b

4.39

(3.84-5.03)b

Patient Characteristics

Age (years)

15-19

    

4.53

(3.23-6.34)b

20-24

    

5.62

(4.04-7.81)b

25-29

    

3.82

(2.73-5.34)b

30-24

    

3.21

(2.28-4.51)b

35-39

    

2.18

(1.53-3.10)b

40-44

    

1.54

(1.08-2.19)

45-49

    

1.41

(0.97-2.03)

50-54

    

1.00

(reference)

Aboriginal Status

Non-Aboriginal

    

1.00

(reference)

Aboriginal

    

1.33

(0.98-1.81)

Not recorded

    

0.96

(0.60-1.54)

Random effects (intercepts)

  State (variance (SE))

0.91

(0.63)

0.55

(0.40)

0.56

(0.40)

  Health Centre (variance (SE))

0.76

(0.14)

0.44

(0.087)

0.43

(0.085)

  State & Health Centre (variance)

1.67

 

0.99

 

0.98

 

  Patient (variance (SE))

0.31

(0.16)

0.11

(0.057)

0.023

(0.013)

  1. CQI continuous quality improvement, MOR Median Odds Ratio: odds of receiving above median service delivery if client was to change health centre or jurisdiction, OR odds Ratio, PCV proportional change in variance: per cent variation explained in odds for better healthcare delivery by introduction of health centre or client level factors, SRH Sexual and Reproductive Health
  2. Due to multiple testing, the significance level is set at p < 0.005 (Bonferroni correction); a p < 0.005; b p < 0.0001
  3. a(n = 6,645 with AHC recorded, introduced to audit tool in 2007)