Evaluating Outcomes Related to Hypertension in Toledo-Lucas County CareNet Patients.

摘要

Introduction. Hypertension is a chronic disease whose management has met with limited success in underserved and low-income populations. Understanding the different factors that help in meeting clinically recommended goals among members of a safety net organization can help in improving the process of care. Studying this population can also provide insight regarding some of the probable causes for lack of progress towards recommended goals.;Objective. To determine blood pressure goal attainment levels and the factors influencing them for hypertension patients in the Toledo-Lucas County CareNet population.;Methods. A retrospective, cohort study was carried out by reviewing patient charts. Eligible subjects were at least 18 years old and had to be enrolled as CareNet members for a minimum duration of one year for the study period of 1st Jan 2003--31st Dec 2008. Descriptive statistics were utilized to determine goal attainment. Chi square analysis was used to determine variables that had significantly different goal attainment. A binomial logit model was used to predict goal attainment. Goal attainment served as the dependent variable and was determined based on JNC-7 guidelines. Age, gender, race/ethnicity, BMI, tobacco use, number of primary care visits, and pharmacotherapy treatment were used as predictor variables.;Results. A total of 269 patients were included in the final analysis. 92 of these patients had diabetes. The overall goal attainment was found to be 42.39% in the patients with diabetes as co-morbidity and 60.45% among the members without diabetes as co-morbidity. Chi-square analysis found significant differences in goal attainment for the variables co-morbidity (p=0.05) and number of visits (p0.01). Number of primary care visits between 6--10 times was found to significantly predict goal attainment (OR=3.705; CI: 1.670--8.218). Notable trends were observed for other variables but the effect was not found to be significant.;Conclusion. Goal attainment among CareNet members was found to be comparable to other studies and national statistics. Encouraging regular utilization of primary care services may further improve the clinical outcomes in a low-income population.