Original scientific paper
Predictors of the quality of cardiovascular prevention – a multilevel cross-sectional study
Davorina Petek
; Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Anuška Ferligoj
; Faculty of Social Sciences, University of Ljubljana, Slovenia
Rok Platinovšek
; Faculty of Social Sciences, University of Ljubljana, Slovenia
Janko Kersnik
; Department of Family Medicine, Faculty of Medicine, University of Maribor, Maribor, Slovenia
Abstract
Aim To attempt to develop a model of predictors for quality
of the process of cardiovascular prevention in patients
at high risk of cardiovascular disease (CVD).
Methods We formed a random sample of patients from a
stratified sample of 36 family practice registers of patients
at high risk of CVD without diabetes and without established
CVD. Data were gathered by chart audit and questionnaires
about patient and practice characteristics. We
defined the process of care as a dependent variable by
principle component analysis and tested the relationship
of the process with several independent variables (family
physicians’, patients’, and practice characteristics). To study
the effects of independent variables (predictors) on the
process of care we carried out multilevel regression analysis
with the patients constituting the lower level and nested
within the family physician/practice (the second level).
Results Multilevel regression analysis included 645 patients
from 36 practices (74.1% from the final sample). Patients’
characteristics that predicted the higher-quality process
of CVD prevention were younger age (t = -4.94, 95%
confidence interval [CI] -0.018 to -0.008) and lower socioeconomic
status (t = -2.18, 95%CI -0.195 to -0.010). Practice
characteristics that predicted the higher-quality process of
CVD prevention were smaller practice size (t = 2.83, 95% CI
0.063 to 1.166), a good information system for CVD prevention
(t = 3.15, 95% CI 0.030 to 0.282), and the organization
of education on CVD prevention (t = 3.19, 95%CI 0.043 to
0.380).
Conclusion This study shows that the quality of cardiovascular
prevention could be measured as a composite
outcome and future studies should further develop this
approach and test the impact of several practice/patient
characteristics on the quality of CVD prevention with the
international data.
Keywords
Quality of health care; cardiovascular diseases; prevention and control; outcome and process assessment; risk assessment; family practice
Hrčak ID:
78202
URI
Publication date:
15.12.2011.
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