Patterns of Medicare-funded primary health and specialist consultations in Aboriginal and non-Aboriginal Australians in the two years before hospitalisation for ischaemic heart disease

Table 4 Multivariable models using negative binomial regression for rates of GP visits (truncated at max 104, allowing maximum of 1 GP visit per week) and specialist consults over 2 years prior to first IHD admission (n = 27,230)

Multivariable model for GP consults					Multivariable model for specialist consults
GP visits (truncated)	IRR	p-value	95% CI		IRR	p-value	95% CI
Age at admission	1.02	< 0.001	1.02	1.02	1.03	< 0.001	1.02	1.03
Female gender	1.32	< 0.001	1.30	1.35	1.32	< 0.001	1.28	1.37
Year of admission	0.96	< 0.001	0.95	0.96	0.95	< 0.001	0.94	0.96
Aboriginal status (1)	1.07	0.004	1.02	1.12	0.44	< 0.001	0.40	0.48
With private medical insurance	0.90	< 0.001	0.88	0.92	1.81	< 0.001	1.75	1.86
ARIA classification
Highly accessible	1.00				1.00
Accessible	0.93	< 0.001	0.91	0.94	0.92	< 0.001	0.89	0.96
Moderately accessible	0.82	< 0.001	0.79	0.84	0.80	< 0.001	0.76	0.84
Remote	0.86	< 0.001	0.80	0.92	0.82	0.002	0.72	0.93
Very remote	0.66	< 0.001	0.63	0.69	0.44	< 0.001	0.40	0.48
Comorbidities
Heart failure	1.04	0.031	1.00	1.09	1.02	0.629	0.95	1.09
Chronic kidney disease	1.19	< 0.001	1.13	1.25	1.53	< 0.001	1.40	1.66
Hypertension	1.17	< 0.001	1.15	1.19	1.07	< 0.001	1.03	1.10
Rheumatic/valvular heart disease	1.14	< 0.001	1.11	1.17	1.25	< 0.001	1.20	1.31
Diabetes	1.33	< 0.001	1.30	1.36	1.47	< 0.001	1.41	1.53
COPD	1.42	< 0.001	1.37	1.48	1.42	< 0.001	1.33	1.52
Cancer	1.2	< 0.001	1.17	1.23	1.71	< 0.001	1.63	1.78
Cerebrovascular disease	1.29	0.002	1.10	1.51	1.23	0.145	0.93	1.63
Stroke	0.98	0.835	0.83	1.16	1.04	0.817	0.77	1.39
Coronary heart disease	0.77	< 0.001	0.70	0.83	0.71	< 0.001	0.61	0.82
Charlson index	0.89	< 0.001	0.88	0.9	0.88	< 0.001	0.86	0.89

IRR = incidence rate ratio; 95% CI = 95% confidence interval
Notes: For age group under 55 years and separately, in patients 55 years and older, there was no significant difference between Aboriginal and non-Aboriginal patients for GP visits (truncated at 104). When restricted to only metropolitan patients, Aboriginal patients had an adjusted IRR of only 0.36 (95% CI 0.31–0.42, p < 0.001) for specialist visits (as a count variable). Having private medical insurance was negatively associated with GP visits but positively with specialist visits, the IRR is 1.84 (95% CI 1.77–1.90) compared with those without private medical insurance

ISSN: 1475-9276