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改善了与大规模高血压计划相关的血压控制.
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
概括
与州和全国平均水平相比,一个大规模的高血压计划显著改善了北加州的血压控制率. 关键要素包括注册,绩效指标,指南和组合药物治疗.
科学领域:
- 公共卫生 公共卫生
- 心血管医学 心血管医学
- 医疗服务研究 医疗服务研究
背景情况:
- 在大量人群中控制高血压是一个重大的公共卫生挑战.
- 需要有效的策略来改善不同患者群体的血压管理.
研究的目的:
- 描述一个大规模的高血压计划在北加州实施.
- 将该计划中的高血压控制率与全州和国家基准进行比较.
主要方法:
- 北加州凯撒永久医院 (Kaiser Permanente Northern California,简称KPNC) 的项目从2001年至2009年间使用了多方面的方法来控制血压.
- 使用国家质量保证委员会 (NCQA) 医疗保健有效性数据和信息集 (HEDIS) 商业指标来测量高血压控制.
- 比较组包括加利福尼亚州的保险患者和参加NCQA HEDIS报告的国家健康计划.
主要成果:
- 到2009年,KPNC的高血压注册表已经增长到超过65万名患者.
- 在KPNC中,高血压控制显著增加,从43.6%增加到80.4% (P < .001).
- 在同一时期,全州和全国的控制率显示出较为温和的增长.
结论:
- 实施KPNC高血压计划与比州和国家平均水平高得多的高血压控制率有关.
- 计划的关键组成部分包括一个全面的注册表,绩效指标,基于证据的指导方针和优化的药物治疗.
- 这些发现凸显了大规模综合计划在改善人口水平高血压管理方面的有效性.
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