Mejor control de la presión arterial asociado con un programa de hipertensión a gran escala
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Marc G Jaffe1, Grace A Lee, Joseph D Young
1Department of Endocrinology, Kaiser Permanente South San Francisco Medical Center, South San Francisco, California 94080, USA. marc.jaffe@kp.org
JAMA
|August 31, 2013
Resumen
Un programa de hipertensión a gran escala mejoró significativamente las tasas de control de la presión arterial en el norte de California en comparación con los promedios estatales y nacionales. Los elementos clave incluían un registro, métricas de rendimiento, pautas y farmacoterapia combinada.
Área de la Ciencia:
- Salud Pública La salud pública.
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Servicios de salud Investigación Servicios de salud Investigación
Sus antecedentes:
- El control de la hipertensión en grandes poblaciones presenta un desafío significativo para la salud pública.
- Se necesitan estrategias efectivas para mejorar el manejo de la presión arterial en diversos grupos de pacientes.
Objetivo del estudio:
- Para describir un programa de hipertensión a gran escala implementado en el norte de California.
- Comparar las tasas de control de la hipertensión dentro de este programa con los puntos de referencia estatales y nacionales.
Principales métodos:
- El programa Kaiser Permanente Northern California (KPNC) utilizó un enfoque multifacético para el control de la presión arterial desde 2001-2009.
- El control de la hipertensión se midió utilizando métricas comerciales del Conjunto de Datos e Información sobre la Eficacia de la Atención Médica (HEDIS) del Comité Nacional para el Aseguramiento de la Calidad (NCQA).
- Los grupos de comparación incluyeron pacientes asegurados en California y planes nacionales de salud que participaron en los informes HEDIS de NCQA.
Principales resultados:
- El registro de hipertensión de KPNC creció a más de 650.000 pacientes en 2009.
- El control de la hipertensión dentro de KPNC aumentó significativamente del 43.6% al 80.4% (P < .001).
- Las tasas de control a nivel estatal y nacional mostraron aumentos más modestos durante el mismo período.
Conclusiones:
- La implementación del programa de hipertensión de KPNC se asoció con tasas de control de la hipertensión sustancialmente más altas que los promedios estatales y nacionales.
- Los componentes clave del programa incluían un registro completo, métricas de rendimiento, pautas basadas en evidencia y farmacoterapia optimizada.
- Estos hallazgos resaltan la efectividad de los programas integrados a gran escala para mejorar la gestión de la hipertensión a nivel de la población.
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