Physician Characteristics as Predictors of Blood Pressure Control in Patients Enrolled in the Hypertension Improvement Project (HIP)

被引:6
作者
Corsino, Leonor [1 ]
Yancy, William S. [1 ,2 ]
Samsa, Gregory P. [3 ]
Dolor, Rowena J. [1 ,2 ]
Pollak, Kathryn I. [4 ,5 ]
Lin, Pao-Hwa [6 ]
Svetkey, Laura P. [1 ,6 ,7 ]
机构
[1] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA
[2] Durham VAMC, Ctr Hlth Serv Res Primary Care, Durham, NC USA
[3] Duke Univ, Dept Biostat & Bioinformat, Durham, NC 27710 USA
[4] Duke Univ, Med Ctr, Canc Prevent Detect & Control Res Program, Durham, NC 27710 USA
[5] Duke Univ, Med Ctr, Dept Community & Family Med, Durham, NC 27710 USA
[6] Duke Univ, Med Ctr, Sarah W Stedman Nutr & Metab Ctr, Durham, NC 27710 USA
[7] Duke Univ, Med Ctr, Duke Hypertens Ctr, Durham, NC 27710 USA
基金
美国国家卫生研究院;
关键词
UNITED-STATES ADULTS; VOLUME; QUALITY; CARE; PREVALENCE; AWARENESS; GENDER;
D O I
10.1111/j.1751-7176.2010.00385.x
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
The authors sought to examine the relationship between physician characteristics and patient blood pressure (BP) in participants enrolled in the Hypertension Improvement Project (HIP). In this cross-sectional study using baseline data of HIP participants, the authors used multiple linear regression to examine how patient BP was related to physician characteristics, including experience, practice patterns, and clinic load. Patients had significantly lower systolic BP (SBP) (-0.2 mm Hg for every 1% increase, P=.008) and diastolic BP (DBP) (-0.1 mm Hg for every 1% increase, P=.0007) when seen by physicians with a higher percentage of patients with hypertension. Patients had significantly higher SBP (0.8 mm Hg for every 1% increase, P=.002) when seen by physicians with a higher number of total clinic visits per day. Patients had significantly lower DBP (-4.4 mm Hg decrease, P=.0002) when seen by physicians with inpatient duties. Physician's volume of patients with hypertension was related to better BP control. However, two indicators of a busy practice had conflicting relationships with BP control. Given the increasing time demands on physicians, future research should examine how physicians with a busy practice are able to successfully address BP in their patients. J Clin Hypertens (Greenwich). 2011;13:106-111. (C)2010 Wiley Periodicals, Inc.
引用
收藏
页码:106 / 111
页数:6
相关论文
共 16 条
[1]   Physician gender is associated with the quality of type 2 diabetes care [J].
Berthold, H. K. ;
Gouni-Berthold, I. ;
Bestehorn, K. P. ;
Boehm, M. ;
Krone, W. .
JOURNAL OF INTERNAL MEDICINE, 2008, 264 (04) :340-350
[2]   A multifaceted intervention to improve blood pressure control: The Guideline Adherence for Heart Health (GLAD) study [J].
Bonds, Denise E. ;
Hogan, Patricia E. ;
Bertoni, Alain G. ;
Chen, Haiying ;
Clinch, C. Randall ;
Hiott, Ann E. ;
Rosenberger, Erica L. ;
Goff, David C. .
AMERICAN HEART JOURNAL, 2009, 157 (02) :278-284
[3]   Why don't physicians follow clinical practice guidelines? A framewouk for improvement [J].
Cabana, MD ;
Rand, CS ;
Powe, NR ;
Wu, AW ;
Wilson, MH ;
Abboud, PAC ;
Rubin, HR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (15) :1458-1465
[4]   Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [J].
Chobanian, AV ;
Bakris, GL ;
Black, HR ;
Cushman, WC ;
Green, LA ;
Izzo, JL ;
Jones, DW ;
Materson, BJ ;
Oparil, S ;
Wright, JT ;
Roccella, EJ .
HYPERTENSION, 2003, 42 (06) :1206-1252
[5]   Trends in Hypertension Prevalence, Awareness, Treatment, and Control Rates in United States Adults Between 1988-1994 and 1999-2004 [J].
Cutler, Jeffrey A. ;
Sorlie, Paul D. ;
Wolz, Michael ;
Thom, Thomas ;
Fields, Larry E. ;
Roccella, Edward J. .
HYPERTENSION, 2008, 52 (05) :818-827
[6]   Hypertension Improvement Project (HIP): study protocol and implementation challenges [J].
Dolor, Rowena J. ;
Yancy, William S., Jr. ;
Owen, William F. ;
Matchar, David B. ;
Samsa, Gregory P. ;
Pollak, Kathryn I. ;
Lin, Pao-Hwa ;
Ard, Jamy D. ;
Prempeh, Maxwell ;
McGuire, Heather L. ;
Batch, Bryan C. ;
Fan, William ;
Svetkey, Laura P. .
TRIALS, 2009, 10
[7]   Hypertension control at physicians' offices in the United States [J].
Fang, Jing ;
Alderman, Michael H. ;
Keenan, Nora L. ;
Ayala, Carma ;
Croft, Janet B. .
AMERICAN JOURNAL OF HYPERTENSION, 2008, 21 (02) :136-142
[8]   Is volume related to outcome in health care? A systematic review and methodologic critique of the literature [J].
Halm, EA ;
Lee, C ;
Chassin, MR .
ANNALS OF INTERNAL MEDICINE, 2002, 137 (06) :511-520
[9]   Is physician gender associated with the quality of diabetes care? [J].
Kim, C ;
McEwen, LN ;
Gerzoff, RB ;
Marrero, DG ;
Mangione, CM ;
Selby, JV ;
Herman, WH .
DIABETES CARE, 2005, 28 (07) :1594-1598
[10]  
Kitahata MM, 2000, J ACQ IMMUN DEF SYND, V24, P106