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Published on: June 6, 2025

Pilot study of a new model for managing hypertension in an uninsured population

James Sanders1, Clare Guse, Berthrand C Onuoha

  • 1Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. jsanders@mcw.edu

Journal of Primary Care & Community Health
|June 27, 2013
PubMed

Insights

The Community-based Chronic Disease Management (CCDM) Clinic successfully improved hypertension control in uninsured patients. This model offers a viable solution for managing chronic diseases in underserved populations.

Area of Science:

  • Public Health
  • Chronic Disease Management
  • Healthcare Delivery Models

Background:

  • Millions of uninsured Americans with hypertension lack regular access to quality medical care due to high costs.
  • The Community-based Chronic Disease Management (CCDM) Clinic was established to provide essential clinical care for uninsured patients in resource-limited, high-need areas.

Purpose of the Study:

  • To evaluate the effectiveness of the novel Community-based Chronic Disease Management (CCDM) model in managing hypertension among uninsured patients.
  • To assess the impact of the CCDM model on achieving national benchmark goals for hypertension control.

Main Methods:

  • A nonrandomized prospective trial was conducted to assess the CCDM model's effectiveness.
  • The intervention involved free patient education, medications, and laboratory investigations.
  • Nurse-led teams utilized evidence-based clinical decision protocols within a chronic disease management framework.

Main Results:

  • After 6 months, 45% of hypertensive patients achieved national benchmark goals, a significant increase from the initial 18%.
  • After 1 year, 56% of patients reached hypertension control goals, up from 22% at presentation.
  • Statistical significance (P < .00005) was observed for goal attainment at both 6 months and 1 year.

Conclusions:

  • The Community-based Chronic Disease Management (CCDM) model demonstrates significant effectiveness in improving hypertension control for uninsured patients.
  • The CCDM model's success suggests potential applicability and positive implications for healthcare service delivery in insured populations.
  • Further research is warranted to explore the broader impact and scalability of the CCDM model in diverse healthcare settings.

Keywords:
community medicinehypertensionmedically uninsuredprimary caretherapy

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