Patient, Clinician, Practice Design, and Treatment Predictors of Cardiovascular Risk Factor Control from Multilevel Regression Analyses
| Domain/Variable | Model Predicting Blood Pressure >130/85 mm Hg (n = 699) OR (95% CI) | Model Predicting LDL-C >100 mg/dL (n = 582) OR (95% CI) |
|---|---|---|
| CI = confidence interval; LDL-C = low-density lipoprotein cholesterol; GED = general equivalency diploma. | ||
| Note: In models predicting poor control, an odds ratio that does not include 1.0 is significant at P <.05. | ||
| * Estimate significant at P <.05. | ||
| † Clinician characteristics and practice design features were entered one at a time after all patient characteristics and treatment are in the model. | ||
| Patient characteristics | ||
| Age | 1.03 (1.02–1.05)* | 0.99 (0.98–1.01) |
| Ethnicity (white is reference group) | ||
| African American | 1.62 (0.96–2.76) | 1.86 (1.08–3.20)* |
| Hispanic | 0.72 (0.39–1.32) | 1.31 (0.69–2.49) |
| Other | 0.57 (0.27–1.20) | 1.16 (0.50–2.69) |
| Sex, male | 0.79 (0.57–1.12) | 0.81 (0.57–1.16) |
| Education (college graduate is reference group) | ||
| Not a high school graduate | 1.63 (1.02–2.63)* | 0.83 (0.51–1.36) |
| High school graduate or GED | 1.44 (0.98–2.10) | 0.90 (0.60–1.36) |
| Duration of diabetes | 0.99 (0.97–1.01) | 0.99 (0.97–1.01) |
| Provider characteristics† | ||
| Years in practice | 1.02 (1.00–1.05) | 0.99 (0.96–1.01) |
| Sex, male | 1.55 (1.00–2.40) | 0.86 (0.53–1.39) |
| No.of patients with diabetes seen in typical month | 1.01 (1.00–1.01) | 1.00 (0.99–1.01) |
| Practice type (single specialty is reference group) | ||
| Academic setting | 0.90 (0.51–1.59) | 0.75 (0.41–1.36) |
| Solo practice | 2.12 (1.14–3.94)* | 0.57 (0.30–1.06) |
| Multispecialty group | 1.13 (0.63–2.00) | 1.33 (0.71–2.49) |
| Combination of settings | 0.81 (0.45–1.46) | 1.12 (0.58–2.16) |
| Practice design features† | ||
| Flow sheets | 0.70 (0.44–1.12) | 1.45 (0.91–2.33) |
| Electronic medical record | 0.91 (0.59–1.39) | 1.09 (0.68–1.72) |
| Involvement of nurse-practitioners or physician’s assistants | 1.35 (0.83–2.22) | 1.15 (0.69–1.92) |
| Patient registries | 0.94 (0.47–1.89) | 1.37 (0.62–3.03) |
| Dietician | 0.85 (0.46–1.56) | 0.61 (0.32–1.19) |
| Diabetes educators | 0.93 (0.53–1.61) | 1.18 (0.66–2.08) |
| Endocrinologists | 1.16 (0.78–1.72) | 1.00 (0.66–1.52) |
| Treatment | ||
| Any antihypertensive or lipid-lowering medication | 1.37 (0.93–2.00) | 0.71 (0.49–1.03) |