Association of Practice Adaptive Reserve and Advance Leadership in Quality Improvement Capability With Target Hypertension
| Quality Improvement Contextual Factors | PR (CI) | P Value | Adjusted PR (CI)a | P Value |
|---|---|---|---|---|
| Leadershipb | ||||
| Low leadership (score 0–1) | 1 [Referent] | 1 [Referent] | ||
| High leadership (score 2–3) | 0.94 (0.57–1.56) | .833 | 0.81 (0.48–1.37) | .429 |
| PAR scorec | ||||
| 0.00 to <0.66 | 1 [Referent] | 1 [Referent] | ||
| 0.65 to <0.76 | 1.47 (0.71–3.03) | .297 | 1.25 (0.52–2.99) | .611 |
| 0.76 to 1.00 | 1.92 (0.9–4.1) | .091 | 1.45 (0.56–3.76) | .440 |
| High leadership+PAR scoresd | ||||
| High leadership | 0.93 (0.57–1.53) | .776 | ||
| PAR (0.65 to <0.76) | 1.48 (0.72–3.05) | .289 | ||
| PAR (0.76 to 1.00) | 1.92 (0.9–4.09) | .089 | ||
PAR=practice adaptive reserve; PR=prevalence ratio.
↵a Modified Poisson regression models adjusted for the following: proportion of commercially insured patients, practice designation as a patient-centered medical home, and clinician-owned practices
↵b PR: prevalence for top quartile hypertension control among practices with high leadership support for quality improvement implementation divided by the prevalence for top quartile hypertension control among practices with less leadership support for quality improvement implementation.
↵c PR: prevalence for achieving top quartile hypertension control among practices with higher quartiles of PAR divided by the prevalence for top quartile hypertension control among practices with the lowest quartile of PAR.
↵d PR reflects adjustments for both high leadership support for quality improvement implementation and higher quartiles of PAR when compared to the referent (low leadership support for quality improvement implementation and lowest quartile of PAR).