Continuity of Care and the Control of High Blood Pressure at Colombian Primary Care Services

Area of Science:

• Cardiovascular Medicine
• Public Health
• Health Services Research

Background:

• Continuity of care (COC) is linked to better health outcomes, including lower mortality and hospitalizations, and improved high blood pressure (HBP) control.
• Existing evidence primarily originates from high-income countries, necessitating research in diverse healthcare settings.
• Understanding factors associated with controlled HBP in low-to-middle-income countries is crucial for global health equity.

Purpose of the Study:

• To investigate the association between continuity of care and controlled high blood pressure in primary care services in Colombia.
• To identify specific conditions related to controlled HBP within different healthcare insurance schemes.

Main Methods:

• A longitudinal observational study was conducted using clinical records of hypertensive adults aged over 18 years.
• Data were collected from primary care services affiliated with two health insurance types (contributive and subsidized) in Cali, Colombia, between 2013 and 2014.
• Continuity of care was assessed using the Bice and Boxerman index, and logistic regression models were employed to analyze the relationship with controlled HBP (<140/90 mmHg).

Main Results:

• Out of 8797 identified hypertensive individuals, 1358 were included in the study.
• A higher continuity of care index was significantly associated with an increased probability of controlled high blood pressure (OR, 2.61).
• Increased visit frequency also correlated with better HBP control, with the fourth visit showing a 34% higher probability of achieving target blood pressure.

Conclusions:

• Continuity of care demonstrates a positive association with controlled high blood pressure in the Colombian primary care setting.
• Enhancing continuity of care is a viable strategy to improve high blood pressure control rates.
• Strengthening continuity of care can contribute to reducing health inequalities in managing hypertension.