Three-Level Hierarchical Model of the Association Between Face-to-Face and EHR Communication Networks and Outcomes for Patients With Cardiovascular Disease (n = 31 teams, n = 7,457 patients)
| Variable | BP Control Adj OR (95% CI) | LDL Cholesterol Control Adj OR (95% CI) | UC Visits Adj RR (95% CI) | ED Visits Adj RR (95% CI) | Hospital Days Adj RR (95% CI) | Cost (US$) Adj β (SE) |
|---|---|---|---|---|---|---|
| Primary care team social networks | ||||||
| Face-to-face interaction density | 1.19 (0.89–1.59) | 1.17a (1.00–1.37) | 0.34a (0.12–0.98) | 0.28b (0.12–0.63) | 0.63 (0.40–1.00) | −594a (240) |
| EHR communication density | 0.96 (0.71–1.29) | 0.85a (0.72–1.00) | 1.64 (0.71–3.81) | 2.34a (1.10–4.97) | 1.010. (63–1.60) | 60 (247) |
| Patient characteristics | ||||||
| Male | 1.52c (1.23–1.87) | 1.67c (1.51–1.88) | 0.79b (0.67–0.93) | 0.94 (0.85–1.04) | 0.97 (0.91–1.03) | 118 (180) |
| Age | 0.99b (0.99–1.00) | 1.01c (1.01–1.02) | 0.96c (0.95–0.97) | 0.98c (0.97–0.99) | 0.99 (0.98–1.00) | −24b (8) |
| Age-squared (÷10) | 1.00 (0.99–1.01) | 0.97c (0.96–0.98) | 1.00 (0.99–1.01) | 1.01c (1.00–1.01) | 1.00 (0.99–1.01) | −1 (3) |
| Non-Hispanic White | 0.58 (0.33–1.01) | 1.22 (0.88–1.69) | 0.64b (0.49–0.84) | 0.68c (0.56–0.81) | 1.52c (1.27–1.83) | 205 (540) |
| White Hispanic | 2.01 (0.97–4.18) | 1.48 (0.91–2.39) | 1.16 (0.78–1.73) | 1.17 (0.87–1.57) | 0.50c (0.34–0.74) | −453 (828) |
| Black | 0.72 (0.49–1.07) | 0.86 (0.56–1.32) | 1.79a (1.05–3.06) | 1.89a (1.03–3.47) | 0.80 (0.32–2.00) | −160 (705) |
| Private insurance | 4.71c (2.44–9.12) | 1.69c (1.36–2.10) | 1.88b (1.27–2.79) | 0.71c (0.59–0.85) | 0.46c (0.42–0.51) | −1,135b (359) |
| Medicaid | 2.64a (1.04–6.73) | 1.40 (0.98–1.99) | 3.18c (2.03–4.97) | 1.45b (1.15–1.84) | 0.81a (0.69–0.95) | −588 (581) |
| Medicare | 3.65c (1.90–7.04) | 2.24c (1.81–2.79) | 1.52a (1.01–2.29) | 1.51c (1.28–1.78) | 0.84c (0.77–0.91) | −817a (364) |
| Charlson comorbidity index | 1.14c (1.09–1.20) | 1.23c (1.20–1.26) | 1.06b (1.02–1.10) | 1.32c (1.29–1.34) | 1.36c (1.34–1.37) | 690c (47) |
Adj OR = adjusted odds ratio; Adj RR = adjusted rate ratio; Adj β = adjusted regression coefficient; BP = blood pressure; ED = emergency department; EHR = electronic health record; LDL = low-density lipoprotein; SE = standard error; UC = urgent care.
Notes: Confidence intervals rounded to 2 significant digits. Statistically significant intervals for OR and RR do not contain 1.
↵a P <.05.
↵b P <.01.
↵c P <.001.