Influence of patient demographics, comorbidity, geographic characteristics and primary care physician characteristics on receipt of rheumatology care within 6 and 12 months
| Characteristic | 6 months | 12 months | ||
|---|---|---|---|---|
| Crude OR (95% CI) | Adjusted‡ OR (95% CI) | Crude OR (95% CI) | Adjusted OR [95% CI] | |
| Demographics | ||||
| Age, mean (± SD) | 1.00 (1.00 to 1.00) | 1.00 (1.00 to 1.00) | 1.00 (1.00 to 1.00) | 1.00 (1.00 to 1.00) |
| Male sex (REF=female) | 0.97 (0.90 to 1.04) | 0.98 (0.91 to 1.06) | 0.92 (0.85 to 1.00) | 0.94 (0.86 to 1.02) |
| Income quintile (REF=1—low) | REF | REF | REF | REF |
| 2 | 1.15 (1.04 to 1.27) | 1.14 (1.03 to 1.26) | 1.07 (0.96 to 1.21) | 1.06 (0.94 to 1.20) |
| 3 | 1.22 (1.10 to 1.35) | 1.20 (1.08 to 1.33) | 1.17 (1.04 to 1.32) | 1.16 (1.03 to 1.31) |
| 4 | 1.15 (1.04 to 1.27) | 1.11 (1.00 to 1.24) | 1.15 (1.02 to 1.30) | 1.12 (0.99 to 1.27) |
| 5 | 1.30 (1.17 to 1.44) | 1.26 (1.13 to 1.40) | 1.35 (1.19 to 1.53) | 1.31 (1.15 to 1.49) |
| Calendar-year of cohort entry (REF=2000) | REF | REF | REF | REF |
| 2001 | 1.07 (0.92 to 1.23) | 1.07 (0.92 to 1.24) | 1.13 (0.96 to 1.34) | 1.13 (0.95 to 1.35) |
| 2002 | 1.12 (0.97 to 1.30) | 1.12 (0.96 to 1.31) | 1.12 (0.95 to 1.33) | 1.14 (0.95 to 1.36) |
| 2003 | 1.19 (1.02 to 1.38) | 1.22 (1.04 to 1.42) | 1.18 (0.99 to 1.40) | 1.21 (1.01 to 1.44) |
| 2004 | 1.01 (0.87 to 1.17) | 1.04 (0.89 to 1.21) | 0.97 (0.82 to 1.15) | 1.01 (0.84 to 1.20) |
| 2005 | 1.15 (1.00 to 1.34) | 1.21 (1.04 to 1.41) | 1.22 (1.02 to 1.45) | 1.30 (1.08 to 1.56) |
| 2006 | 1.25 (1.07 to 1.45) | 1.30 (1.11 to 1.52) | 1.28 (1.07 to 1.53) | 1.33 (1.10 to 1.60) |
| 2007 | 1.29 (1.11 to 1.50) | 1.37 (1.17 to 1.60) | 1.33 (1.11 to 1.59) | 1.42 (1.18 to 1.72) |
| 2008 | 1.26 (1.09 to 1.47) | 1.35 (1.16 to 1.58) | 1.30 (1.09 to 1.55) | 1.41 (1.17 to 1.70) |
| 2009 | 1.42 (1.21 to 1.66) | 1.49 (1.26 to 1.76) | 1.83 (1.51 to 2.22) | 1.96 (1.60 to 2.40) |
| Comorbidity | ||||
| Number of Hopkins ADGs (REF≤5) | REF | REF | REF | REF |
| 5–9 | 1.02 (0.94 to 1.10) | 1.03 (0.95 to 1.12) | 1.03 (0.94 to 1.13) | 1.07 (0.97 to 1.18) |
| 10+ | 1.02 (0.93 to 1.12) | 1.05 (0.95 to 1.16) | 1.04 (0.93 to 1.16) | 1.09 (0.97 to 1.23) |
| Hospitalisation for RA prior to rheumatologist visit/end of study period | 0.60 (0.42 to 0.85) | 0.63 (0.44 to 0.91) | 0.51 (0.36 to 0.71) | 0.54 (0.38 to 0.76) |
| Geographic | ||||
| Patient rural residence (REF=urban) | 0.74 (0.68 to 0.81) | 1.00 (0.89 to 1.11) | 0.80 (0.72 to 0.89) | 1.09 (0.96 to 1.24) |
| Rheumatology supply per 100 000 adults | 1.15 (1.11 to 1.20) | 1.19 (0.97 to 1.45) | 1.16 (1.11 to 1.22) | 1.25 (0.98 to 1.61) |
| Remote distance (≥100 km to rheumatologist) | 0.28 (0.24 to 0.33) | 0.46 (0.36 to 0.59) | 0.26 (0.22 to 0.31) | 0.33 (0.26 to 0.43) |
| Primary care physician | ||||
| Male sex (REF=female) | 0.81 (0.74 to 0.89) | 0.89 (0.81 to 0.97) | 0.81 (0.73 to 0.90) | 0.91 (0.81 to 1.01) |
| Years since graduation | 1.00 (0.99 to 1.00) | 0.99 (0.99 to 1.00) | 1.00 (0.99 to 1.00) | 0.99 (0.99 to 1.00) |
| Practice type†(REF=fee-for-service) | ||||
| Capitation model | 1.22 (1.01 to 1.47) | 1.13 (0.93 to 1.36) | 1.22 (0.99 to 1.51) | 1.09 (0.87 to 1.35) |
*Adjusted for all covariates including: patient demographics, clinical factors, primary care physician characteristics, provider continuity and geographical characteristics (including regional variation by regional health service planning areas LHINs not reported here).
†Practice types: blended capitation models (FHNs, FHOs, FHTs, an interprofessional team model composed of FHNs and FHOs), enhanced fee-for-service models (FHGs and other groups) and traditional fee-for-service.
ADG, Adjusted Diagnostic Groups; FGH, Family Health Group; FHN, Family Health Network; FHO, Family Health Organisation; FHT, Family Health Team; LHIN, Local Health Integration Network.