OBJECTIVES: Patients with hypertension require life-long care and should be monitored to identify whether they are receiving the appropriate healthcare and reach their expected health outcomes. Our objectives were to develop quality of healthcare indicators (QCI) and evaluate the quality of care that hypertensive patients receive in family medicine clinics at the Mexican Institute of Social Security. METHOD: We used a two-stage mixed methods approach: development of QCIs following the RAND-UCLA method; quality of care evaluation using electronic health record (EHR) data from 47 150 hypertensive patients who received care in 2009. We developed 15 QCIs, which were possible to construct using EHR data. The QCIs evaluated the process of care and health outcomes. RESULTS: Most hypertensive patients were women (64%) more than 60 years old; 79% were overweight/obese and 31% had diabetes. On average, these patients attended regularly to the family doctor (≥7 visits a year); however, they received only 27% of recommended care. Among the hypertensive patients without comorbidity, 62% had achieved blood pressure (BP) control, whereas in the group of hypertensive patients with diabetes or chronic kidney disease, only 7% had achieved BP control. CONCLUSION: EHR can become a source of information to evaluate routinely quality of care in developing countries that are beginning to modernize their health information systems.
OBJECTIVES:Patients with hypertension require life-long care and should be monitored to identify whether they are receiving the appropriate healthcare and reach their expected health outcomes. Our objectives were to develop quality of healthcare indicators (QCI) and evaluate the quality of care that hypertensivepatients receive in family medicine clinics at the Mexican Institute of Social Security. METHOD: We used a two-stage mixed methods approach: development of QCIs following the RAND-UCLA method; quality of care evaluation using electronic health record (EHR) data from 47 150 hypertensivepatients who received care in 2009. We developed 15 QCIs, which were possible to construct using EHR data. The QCIs evaluated the process of care and health outcomes. RESULTS: Most hypertensivepatients were women (64%) more than 60 years old; 79% were overweight/obese and 31% had diabetes. On average, these patients attended regularly to the family doctor (≥7 visits a year); however, they received only 27% of recommended care. Among the hypertensivepatients without comorbidity, 62% had achieved blood pressure (BP) control, whereas in the group of hypertensivepatients with diabetes or chronic kidney disease, only 7% had achieved BP control. CONCLUSION: EHR can become a source of information to evaluate routinely quality of care in developing countries that are beginning to modernize their health information systems.
Authors: Angela Y Chang; F Xavier Gómez-Olivé; Jennifer Manne-Goehler; Alisha N Wade; Stephen Tollman; Thomas A Gaziano; Joshua A Salomon Journal: Bull World Health Organ Date: 2018-10-31 Impact factor: 9.408