The association between processes, structures and outcomes of secondary prevention care among VA ischemic heart disease patients

Table 3 Multivariable analyses for the association between the hypothesis variables and guideline concordance^*#

Hypothesis variables	LDL concordance (95% CI; p-value)	BP concordance (95% CI; p-value)
Patient factors
Age (per 10 year increment)	0.94 (0.91–0.97; p < 0.01)	0.86 (0.83–0.89; p < 0.01)
Distance to medical center (per 25 mile increment)	0.99 (0.99–1.00; p = 0.19)	0.99 (0.99–1.00; p = 0.30)
Diabetes	1.44 (1.35–1.54; p < 0.01)	1.01 (0.94–1.08; p = 0.89)
Vascular disease^&	0.99 (0.91–1.07; p = 0.76)	0.91 (0.84–0.99; p = 0.03)
Processes of care
Total medications (per 1 medication increment)	1.01 (1.00–1.01; p < 0.01)	1.01 (1.00–1.01; p = 0.03)
Total Visits (per 1 visit increment)	1.02 (1.01–1.02; p < 0.01)	1.02 (1.01–1.02; p < 0.01)
Recent cardiac hospitalization	1.28 (1.11–1.49; p < 0.01)	1.34 (1.14–1.57; p < 0.01)
Structures of care
Clinic volume	1.01 (1.00–1.02; p = 0.76)	0.82 (0.68–0.99; p < 0.01)
On-site cardiologist	1.14 (1.00–1.30; p = 0.04)	1.10 (0.99–1.22; p = 0.10)

*The cumulative logit model estimates the probability that each subject is in a lower (i.e., better) category compared to a higher (i.e., worse) category of guideline concordance. The reported odds ratio is the probability of being in a lower category (i.e., better concordance) compared to a higher category (i.e., worse concordance). The outcome categories for LDL were the following: 0) LDL measurement and LDL <100 mg/dl, 1) LDL measurement, but LDL≥100 mg/dl, and 2) no LDL measurement. The outcome categories for BP were the following: 0) SBP<140 and DBP<90 mm Hg; 1) SBP≥140 or DBP≥90 mm Hg, and 2) no BP measurement.
#Candidate covariates included all Table 1 and 2 variables.
&Presence of cerebrovascular and/or peripheral vascular disease

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