Multilevel multivariable logistic regression for patient-reported after-hours access, by geography
| Variable | OR (95% CI)* | |||
|---|---|---|---|---|
| Total sample (RIO 0–39) | Large urban (RIO 0) | Medium urban (RIO 1–9) | Small urban (RIO 10–39) | |
| Main exposure | ||||
| Access bonus quintile | ||||
| 1 (lowest) | Ref. | Ref. | Ref. | Ref. |
| 2 | 1.26 (1.09–1.47) | 1.36 (1.13–1.64) | 1.41 (1.07–1.85) | 1.18 (0.64–2.19) |
| 3 | 1.46 (1.23–1.74) | 1.84 (1.47–2.30) | 1.55 (1.14–2.12) | 1.07 (0.58–1.98) |
| 4 | 1.77 (1.46–2.15) | 2.36 (1.81–3.09) | 1.95 (1.39–2.73) | 1.36 (0.75–2.48) |
| 5 (highest) | 1.88 (1.52–2.32) | 1.92 (1.39–2.65) | 2.50 (1.70–3.68) | 1.69 (0.93–3.07) |
| ICC, practice, % | 17.25 | 13.03 | 17.67 | 22.85 |
| ICC, physician, % | 5.66 | 4.80 | 6.99 | 4.53 |
| Patient, n | 10 778 | 4642 | 3542 | 2594 |
| Sex | ||||
| Male | Ref. | Ref. | Ref. | Ref. |
| Female | 1.57 (1.46–1.68) | 1.76 (1.58–1.96) | 1.39 (1.23–1.57) | 1.54 (1.33–1.79) |
| Age, yr | ||||
| < 18 | Ref. | Ref. | Ref. | Ref. |
| 19–34 | 1.66 (1.26–2.17) | 2.04 (1.34–3.08) | 1.55 (0.96–2.51) | 1.42 (0.81–2.48) |
| 35–49 | 2.45 (1.88–3.19) | 3.13 (2.09–4.69) | 2.52 (1.57–4.06) | 1.66 (0.96–2.86) |
| 50–64 | 2.47 (1.90–3.20) | 3.06 (2.06–4.57) | 2.69 (1.69–4.29 | 1.59 (0.94–2.71) |
| 65–74 | 2.38 (1.83–3.10) | 3.19 (2.13–4.77) | 2.71 (1.69–4.34) | 1.35 (0.79–2.32) |
| ≥ 75 | 1.82 (1.39–2.38) | 2.22 (1.47–3.33) | 1.84 (1.14–2.97) | 1.30 (0.75–2.26) |
| Education | ||||
| Some high school or less | Ref. | Ref. | Ref. | Ref. |
| High school | 1.13 (0.99–1.28) | 1.13 (0.91–1.41) | 1.04 (0.83–1.30) | 1.19 (0.93–1.51) |
| Some postsecondary | 1.13 (0.97–1.33) | 1.20 (0.93–1.55) | 1.12 (0.85–1.46) | 1.01 (0.74–1.37) |
| College | 1.29 (1.13–1.48) | 1.29 (1.04–1.61) | 1.31 (1.04–1.64) | 1.25 (0.97–1.60) |
| University | 1.28 (1.11–1.47) | 1.37 (1.10–1.71) | 1.21 (0.95–1.53) | 1.15 (0.87–1.52) |
| Postgraduate | 1.33 (1.14–1.55) | 1.46 (1.15–1.85) | 1.13 (0.85–1.49) | 1.27 (0.89–1.81) |
| Primary language | ||||
| Other | Ref. | Ref. | Ref. | Ref. |
| English, English & French, English & other | 1.62 (1.37–1.92) | 1.57 (1.26–1.95) | 1.81 (1.32–2.48) | 1.23 (0.67–2.25) |
| French | 1.11 (0.83–1.48) | 0.87 (0.57–1.33) | 1.43 (0.88–2.33) | 0.73 (0.32–1.64) |
| Health status | ||||
| Poor | Ref. | Ref. | Ref. | Ref. |
| Fair | 1.09 (0.90–1.32) | 0.98 (0.72–1.33) | 1.21 (0.87–1.69) | 0.94 (0.64–1.39) |
| Good | 1.05 (0.88–1.26) | 1.00 (0.75–1.34) | 1.12 (0.83–1.52) | 0.89 (0.63–1.26) |
| Very good | 1.18 (0.99–1.41) | 1.12 (0.84–1.49) | 1.21 (0.89–1.64) | 1.03 (0.73–1.46) |
| Excellent | 1.04 (0.86–1.25) | 0.97 (0.72–1.31) | 1.04 (0.75–1.43) | 0.99 (0.68–1.43) |
| Income quintile | ||||
| 1 (lowest) | Ref. | Ref. | Ref. | Ref. |
| 2 | 1.03 (0.92–1.17) | 1.11 (0.93–1.33) | 1.03 (0.83–1.28) | 0.96 (0.75–1.24) |
| 3 | 1.09 (0.97–1.22) | 0.96 (0.80–1.14) | 1.31 (1.07–1.61) | 1.17 (0.91–1.49) |
| 4 | 1.16 (1.03–1.30) | 1.19 (1.00–1.41) | 1.27 (1.04–1.55) | 1.10 (0.87–1.41) |
| 5 | 1.09 (0.97–1.22) | 1.05 (0.89–1.25) | 1.25 (1.03–1.53) | 1.01 (0.79–1.29) |
| Immigrant status | ||||
| Yes | Ref. | Ref. | Ref. | Ref. |
| No | 1.24 (1.13–1.36) | 1.24 (1.09–1.41) | 1.34 (1.13–1.59) | 1.17 (0.93–1.48) |
| Physician, n | 3940 | 2026 | 1222 | 692 |
| Age | 0.99 (0.99–1.00) | 1.00 (0.99–1.00) | 0.99 (0.99–1.00) | 0.99 (0.99–1.00) |
| Sex | ||||
| Male | Ref. | Ref. | Ref. | Ref. |
| Female | 1 (0.91–1.09) | 0.97 (0.85–1.11) | 1 (0.85–1.19) | 1.12 (0.90–1.38) |
| Canadian graduate | ||||
| No | Ref. | Ref. | Ref. | Ref. |
| Yes | 1.09 (0.98–1.20) | 1.03 (0.88–1.21) | 1.11 (0.93–1.33) | 1.18 (0.95–1.47) |
| Years in practice (per 5-yr increase) | 1.00 (0.94–1.07) | 1.07 (0.97–1.18) | 0.96 (0.85–1.07) | 1.10 (0.98–1.25) |
| Roster size (per 100-patient increase) | 0.90 (0.83–0.96) | 0.83 (0.74–0.92) | 0.92 (0.81–1.04) | 1.02 (0.87–1.20) |
| Practice, n | 414 | 210 | 130 | 74 |
| Group size (per 10-member increase) | 1.12 (1.02–1.23) | 1.17 (1.03–1.33)* | 1.05 (0.90–1.22) | 1.08 (0.87–1.34) |
| Number of after-hours services (per 500-hr increase) | 1.00 (0.89–1.12) | 0.98 (0.85–1.12) | 0.98 (0.83–1.16) | 1.05 (0.81–1.36) |
| Practice model | ||||
| Not team-based | Ref. | Ref. | Ref. | Ref. |
| Team-based | 1.23 (0.99–1.52) | 1.47 (1.13–1.93) | 1 (0.66–1.51) | 1.29 (0.78–2.14) |
Note: CI = confidence interval, ICC = intraclass correlation coefficient, OR = odds ratio, Ref. = reference, RIO = Rurality Index of Ontario.
↵* Unless indicated otherwise.