Krousel-Wood MA, Hincapie L, Boulos LM, Gomez NF, Chambers R.
AHSR FHSR Annu Meet Abstr Book. 1996; 13: 110.
Ochsner Medical Foundation Hospital, New Orleans, LA 70121, USA.
RESEARCH OBJECTIVES: We used the HTN TyPE (Technology of Patient Experience) tool to retrospectively assess potential HTN patient outcome differences by HTN subspecialist vs. family practitioner. STUDY POPULATION: This study included 137 patients with essential HTN cared for in a large multispecialty clinic: 44% men, 84% white, 66% married, 51% Medicare, mean age 68 years (+/-13 standard deviation). STUDY DESIGN: A retrospective cohort study design was employed. Patients were identified in the administrative database by ICD-9 code 401.9. Medical record review was performed by 2 research technicians using the HTN TyPE tool from HOI; inter-rater reliability was determined. Baseline data was collected </=1992; follow-up data was collected from Jan 1993 to Sept 1994 (1.75 years). Independent variables assessed included patient demographics, comorbidity, year (1992 baseline vs. 1993-1994 follow-up), provider, medication class, and selected laboratory values. Bivariate and logistic regression analysis were done. PRINCIPAL FINDINGS: 137 patient records were reviewed: 33% of the patients received care from HTN subspecialist; 67% from family practitioners. Inter-rater reliability was good. HTN-related outcomes were assessed: stroke, blood pressure, angina, AV nicking, cardiomegaly, congestive heart failure, myocardial infarction, others. Bivariate analysis revealed potential for significant differences in outcomes by provider. Logistic regression analysis revealed that cardiomegaly and congestive heart failure were related to provider; the other outcomes were independent of provider category. CONCLUSIONS: Within a 1.75 year follow-up period there are few differences in HTN-related outcomes by provider. Longitudinal study will be necessary to fully evaluate differences by provider and the ability of the HTN TyPE tool to detect these differences. RELEVANCE TO CLINICAL PRACTICE AND HEALTH CARE DELIVERY: This study incorporates the use of the Hypertension Technology of Patient Experience (TyPE) outcomes tool that may be useful in clinical practice for monitoring individual patient outcomes and for assessing potential change in outcomes groups of patients. For chronic conditions like hypertension, long-term follow-up periods may be necessary to assess potential differences in outcomes over time.
Publication Types:
Keywords:
- Academies and Institutes
- Ambulatory Care Facilities
- Antigua
- Blood Pressure
- Blood Pressure Determination
- Cardiomegaly
- Comorbidity
- Heart Failure
- Humans
- Hypertension
- Longitudinal Studies
- Male
- Myocardial Infarction
- Regression Analysis
- Stroke
- utilization
- hsrmtgs
Other ID:
UI: 102222276
From Meeting Abstracts