Reaching Urban Poor Hypertensive Patients: A Novel Model of Chronic Disease Care Versus a Traditional Fee-for-Service...

Area of Science:

• Public Health
• Cardiovascular Medicine
• Health Services Research

Background:

• Hypertension treatment rates significantly differ between insured and uninsured populations.
• Untreated hypertension leads to severe morbidity and mortality.
• The uninsured encounter substantial barriers to chronic disease care access.

Purpose of the Study:

• To evaluate the effectiveness of Community-based Chronic Disease Management (CCDM) clinics compared to traditional models for hypertension control.
• To determine if the CCDM model achieves blood pressure goals similarly to fee-for-service clinics.

Main Methods:

• A comparative study was conducted between CCDM clinics and two traditional fee-for-service physician-led clinics.
• All clinics were situated in similar low-income urban neighborhoods in Milwaukee, Wisconsin.
• Hypertensive care outcomes, specifically blood pressure control, were assessed at 6 months.

Main Results:

• Patients in both CCDM and traditional clinics demonstrated statistically significant improvements in reaching blood pressure goals at 6 months.
• Logistic regression analysis revealed no significant difference in achieving blood pressure control between CCDM and fee-for-service clinics.
• The CCDM model proved equally effective in managing hypertension for the studied population.

Conclusions:

• The CCDM model of care is a viable and effective alternative for controlling hypertension in underserved populations.
• This nurse-led, community-based approach offers a promising strategy for engaging the urban poor in chronic disease management.
• CCDM clinics provide essential services, including laboratory tests and medications, free of charge on-site.