Disparities in Hypertension Control Across and Within Three Health Systems Participating in a Data-Sharing Collaborative.

Details

Serval ID
serval:BIB_DFA127428E7C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Disparities in Hypertension Control Across and Within Three Health Systems Participating in a Data-Sharing Collaborative.
Journal
Journal of the American Board of Family Medicine
Author(s)
Selby K., Michel M., Gildengorin G., Karliner L., Pramanik R., Fontil V., Potter M.B.
ISSN
1558-7118 (Electronic)
ISSN-L
1557-2625
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
31
Number
6
Pages
897-904
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
We aimed to standardize data collection from 3 health systems (HS1, HS2, HS3) participating in the San Francisco Bay Collaborative Research Network, and compare rates and predictors of uncontrolled blood pressure among hypertensive adults to identify opportunities for regional collaboration in quality improvement.
Retrospective cohort study using deidentified electronic health record data from all primary care patients with at least 1 visit in a 2-year period, using standard data definitions in a common data repository. Primary outcome was uncontrolled blood pressure at the most recent primary care visit.
Of 169,793 adults aged 18 to 85 years, 53,133 (31.3%) had a diagnosis of hypertension. Of these, 18,751 (35%) had uncontrolled blood pressure at their last visit, with the proportion varying by system (29%, HS1; 31%, HS2; and 44%, HS3) and by clinical site within each system. In multivariate analyses, differences between health systems persisted, with HS2 and HS3 patients having a 1.15 times (95% CI, 1.11 to 1.19) and 1.46 times (95% CI, 1.42 to 1.50) greater relative risk of uncontrolled blood pressure compared with HS1. Across health systems, hypertensive patients were more likely to have uncontrolled blood pressure if they were uninsured, African Americans, current smokers, obese, or had fewer than 2 primary care visits during the 2-year measurement period.
After controlling for standard individual predictors of hypertension control, significant and substantial differences in hypertension control persisted between health systems, possibly due to local quality improvement programs among other factors. There may be opportunities to share best practices and address common disparities across health systems.
Keywords
Blood Pressure, Hypertension, Multivariate Analysis, Primary Health Care, Retrospective Studies Quality Improvement
Pubmed
Web of science
Open Access
Yes
Create date
20/11/2018 10:04
Last modification date
04/03/2020 6:26
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