Exploring the Characteristics Associated With Diabetes and Hypertension Performance in Community Health Centers

Large portions of patients served at community health centers have diabetes or hypertension. This study aimed to identify the factors related to diabetes and hypertension performance among community health centers.

The authors estimated multivariable linear regression models to examine the association of characteristics (percentage of patients at high risk of cardiovascular events on statin therapy, female, overweight or obese, homeless, veterans, gender minorities, sexual orientation minorities, best served in a non-English language, or with diabetes or hypertension and log of revenue per patient) with diabetes (proportion of patients with HbA1c >9.0) and hypertension (proportion of patients with high blood pressure) control. The sample included community health centers in the 2023 Uniform Data System data set.

Variables significantly associated with lower diabetes control were percentage of patients who were unhoused (0.10; 95% CI=0.07, 0.13) and patients best served in a non-English language (0.03; 95% CI=0.01, 0.05); variables significantly associated with higher diabetes control were percentage of patients who were at high risk of cardiovascular events and on statin therapy (-0.17; 95% CI= -0.22, -0.12) and those who were veterans (-0.86; 95% CI= -1.12, -0.59); variables significantly associated with lower hypertension control were percentage of patients who were unhoused (0.06; 95% CI=0.03, 0.09) and patients who were hypertensive (0.10; 95% CI=0.04, 0.16) and log of revenue per patient (0.73; 95% CI=0.17, 1.30); and variables significantly associated with higher hypertension control were percentage of patients who were at high risk of cardiovascular events and on statin therapy (-0.35 95% CI= -0.39, -0.30), patients who were overweight or obese (-0.04; 95% CI= -0.07, -0.01), and veterans (-0.82; 95% CI= -1.08, -0.55).

Community health centers with higher proportions of unhoused patients may require extra support. Encouraging delivery of evidence-based care may help performance.