Table 4

Multivariable associations between process measures and the likelihood of all-cause hospitalisations among older adults with selected disease combinations

CharacteristicDiabetes with comorbid hypertension n=273 592Diabetes with comorbid hypertension and chronic ischaemic heart disease n=141 947Diabetes with comorbid osteoarthritis n=255 214Diabetes with comorbid osteoarthritis and major depression n=2444
All-cause hospitalisations
AOR (95% CI)
All-cause hospitalisations
AOR (95% CI)
All-cause hospitalisations
AOR (95% CI)
All-cause hospitalisations
AOR (95% CI)
Having HbA1c tests
 NoRef.Ref.Ref.Ref.
 1 or 2 HbA1c tests0.90 (0.88 to 0.92)0.88 (0.85 to 0.91)0.88 (0.86 to 0.90)0.93 (0.76 to 1.13)
 3 or more HbA1c tests0.84 (0.82 to 0.86)0.86 (0.83 to 0.88)0.83 (0.81 to 0.85)0.82 (0.69 to 1.03)
Annual eye examination
 NoRef.Ref.Ref.Ref.
 Yes0.85 (0.84 to 0.87)0.90 (0.88 to 0.92)0.89 (0.87 to 0.91)0.85 (0.75 to 0.97)
Use of oral hypoglycaemic drugs
 NoRef.Ref.Ref.Ref.
 Yes0.88 (0.86 to 0.90)0.88 (0.86 to 0.90)0.92 (0.89 to 0.93)0.93 (0.78 to 1.10)
Use of ACE inhibitors
 NoRef.Ref.
 Yes1.04 (0.99 to 1.06)1.03 (0.98 to 1.05)
Use of ARBs
 NoRef.Ref.
 Yes0.93 (0.92 to 1.02)0.98 (0.96 to 1.01)
Use of antiplatelet drugs
 No Ref.
 Yes1.08 (1.06 to 1.11)
Use of statins
 No Ref.
 Yes0.89 (0.86 to 0.92)
Use of NSAIDs
 NoRef.Ref.
 Yes0.99 (0.97 to 0.99)0.99 (0.88 to 1.12)
Use of tetracyclic antidepressants
 NoRef.
 Yes1.14 (0.86 to 1.32)
Use of benzodiazepines
 NoRef.
 Yes1.33 (1.20 to 1.48)
Continuity of Care (COC) index*
 COC ≤median valueRef.Ref.Ref.Ref.
 COC >median value0.70 (0.69 to 0.72)0.74 (0.72 to 0.77)0.73 (0.72 to 0.74)0.84 (0.72 to 0.93)
Number of drugs1.06 (1.04 to 1.07)1.05 (1.02 to 1.07)1.06 (1.04 to 1.08)1.06 (1.05 to 1.07)
Age1.04 (1.03 to 1.05)1.03 (1.02 to 1.04)1.03 (1.02 to 1.04)1.02 (1.01 to 1.04)
Sex
 FemaleRef.Ref.Ref.Ref.
 Male1.40 (1.36 to 1.44)1.15 (1.12 to 1.18)1.22 (1.20 to 1.24)1.15 (0.97 to 1.23)
Income quintiles
 Q1 lowest incomeRef.Ref.Ref.Ref.
 Q20.93 (0.90 to 0.97)0.99 (0.97 to 1.03)1.02 (0.96 to 1.05)1.02 (0.79 to 1.3)
 Q30.95 (0.90 to 0.99)1.03 (0.99 to 1.07)0.97 (0.94 to 0.99)0.99 (0.78 to 1.28)
 Q40.89 (0.83 to 0.93)1.05 (0.98 to 1.09)0.97 (0.94 to 0.99)1.03 (0.79 to 1.34)
 Q5 highest income0.87 (0.82 to 0.92)1.04 (0.95 to 1.07)1.48 (1.40 to 1.56)1.05 (0.82 to 1.35)
RIO index†
 ≤40Ref.Ref.Ref.Ref.
 >401.14 (1.09 to 1.19)1.16 (1.12 to 1.20)1.27 (0.95 to 1.57)
Duration of diabetes1.03 (1.01 to 1.05)1.02 (1.01 to 1.03)1.19 (1.16 to 1.24)1.01 (0.99 to 1.02)
Duration of hypertension1.02 (1.01 to 1.03)1.01 (1.00 to 1.03)1.02 (1.01 to 1.03)
Duration of ischaemic heart disease1.01 (1.00 to 1.02)
Duration of osteoarthritis0.99 (0.97 to 1.01)0.92 (0.97 to 1.03)
Duration of depression0.95 (0.89 to 1.01)
Number of primary care visits1.02 (1.0 to 1.04)1.01 (1.00 to 1.03)1.02 (1.01 to 1.03)1.02 (1.01 to 1.03)
Primary care models‡
 Capitated+Ref.Ref.Ref.Ref.
 Fee-for-service0.77 (0.76 to 0.79)0.78 (0.76 to 0.80)0.77 (0.76 to 0.78)0.83 (0.68 to 1.02)
 Capitated1.09 (1.02 to 1.13)1.08 (0.99 to 1.13)1.04 (1.02 to 1.06)0.97 (0.51 to 1.89)
Comorbidities
 0 CCRef.Ref.Ref.Ref.
 1 CC1.17 (1.13 to 1.22)1.21 (1.16 to 1.27)1.10 (1.04 to 1.15)0.81 (0.62 to 1.02)
 2 CC1.37 (1.33 to 1.40)1.43 (1.37 to 1.48)1.26 (1.19 to 1.32)1.05 (0.68 to 1.21)
 3 CC1.65 (1.58 to 1.70)1.69 (1.61 to 1.75)1.48 (1.40 to 1.56)1.27 (0.71 to 1.81)
 4 CC2.00 (1.89 to 2.12)1.98 (1.89 to 2.09)1.77 (1.68 to 1.86)1.39 (0.82 to 1.98)
 5 or more CC2.32 (2.16 to 2.44)2.27 (2.15 to 2.35)2.12 (1.60 to 1.46)1.55 (0.97 to 2.23)
  • *Calculated using the Bice index.

  • †Geographic location (≤40=non-rural; >40=rural).

  • ‡Noncapitated models include nonrostered models and those that operate on a fee-for-service basis; capitated models include family health networks and family health organisations operating on a capitation funding scheme; and the capitated + models include family health teams and other rostered models operating on a capitated funding scheme with additional incentives for interdisciplinary care.

  • AOR, adjusted OR; ARBs, angiotensin II receptor blockers; HbA1c, glycated haemoglobin; NSAIDs, non-steroidal anti-inflammatory drugs.