TY - JOUR
T1 - Relationship Between Primary Care Physician Visits and Hospital/Emergency Use for Uncomplicated Hypertension, an Ambulatory Care-Sensitive Condition
AU - Hypertension Outcome and Surveillance Team
AU - Walker, Robin L.
AU - Chen, Guanmin
AU - McAlister, Finlay A.
AU - Campbell, Norm R.C.
AU - Hemmelgarn, Brenda R.
AU - Dixon, Elijah
AU - Ghali, William
AU - Rabi, Doreen
AU - Tu, Karen
AU - Jette, Nathalie
AU - Quan, Hude
N1 - Funding Information:
This project was funded by Canadian Institutes of Health Research grant number: MOP-97823 , and the Libin Cardiovascular Institute of Alberta . The researchers had independence from the funding agency. R.L.W. is supported by the Vanier Canada Graduate Scholarship, Alberta Innovates-Health Solutions (AIHS) graduate studentship and Izaak Walton Killam Memorial Scholarship. Salary support for H.Q. and F.A.M. is from AIHS; K.T. is supported from a Fellowship in Primary Care Research by the Canadian Institute for Health Research ; N.R.C.C. holds the Heart and Stroke Foundation of Canada CIHR Chair in Hypertension Prevention and Control . N.J. holds a Canada Research Chair in Neurological Health Services Research and an AIHS Population Health Investigator Award. This study is based in part on de-identified data provided by Canadian provincial health ministry. The interpretation and conclusions contained, herein, are those of the researchers and do not represent the views of these provincial governments. The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources.
Publisher Copyright:
© 2014 Canadian Cardiovascular Society.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Background: Hospitalizations for ambulatory care-sensitive conditions (ACSCs) represent an indirect measure of access and quality of community care. The purpose of this study was to examine the association between one ACSC, uncomplicated hypertension, and previous primary care physician (PCP) utilization. Methods: A cohort of patients with hypertension was identified using administrative databases in Alberta between fiscal years 1994 and 2008. We applied the Canadian Institute for Health Information's case definition to detect patients with uncomplicated hypertension as the most responsible reason for hospitalization and/or Emergency Department (ED) visit. We assessed hypertension-related and all-cause PCP visits. Results: The overall adjusted rate of ACSC hospitalizations and ED visits for uncomplicated hypertension was 7.1 and 13.9 per 10,000 hypertensive patients, respectively. The likelihood of ACSC hospitalization for uncomplicated hypertension was associated with age, household income quintile, region of residence, and Charlson comorbidity status (all P < 0.0001). The adjusted rate of ACSC hospitalizations for uncomplicated hypertension increased from 4.8 per 10,000 hypertensive patients for those without hypertension-related PCP visits before diagnosis to 10.5 per 10,000 hypertensive patients for those with 5 or more hypertension-related PCP visits. The rate of ACSC hospitalizations and/or ED visits for uncomplicated hypertension increased as the number of hypertension-related PCP visits increased even after stratifying according to demographic and clinical characteristics. Conclusions: As the frequency of hypertension-related PCP visits increased, the rate of ACSC hospitalizations and/or ED visits for uncomplicated hypertension increased. This suggests that ACSC hospitalization for uncomplicated hypertension might not be a particularly good indicator for access to primary care.
AB - Background: Hospitalizations for ambulatory care-sensitive conditions (ACSCs) represent an indirect measure of access and quality of community care. The purpose of this study was to examine the association between one ACSC, uncomplicated hypertension, and previous primary care physician (PCP) utilization. Methods: A cohort of patients with hypertension was identified using administrative databases in Alberta between fiscal years 1994 and 2008. We applied the Canadian Institute for Health Information's case definition to detect patients with uncomplicated hypertension as the most responsible reason for hospitalization and/or Emergency Department (ED) visit. We assessed hypertension-related and all-cause PCP visits. Results: The overall adjusted rate of ACSC hospitalizations and ED visits for uncomplicated hypertension was 7.1 and 13.9 per 10,000 hypertensive patients, respectively. The likelihood of ACSC hospitalization for uncomplicated hypertension was associated with age, household income quintile, region of residence, and Charlson comorbidity status (all P < 0.0001). The adjusted rate of ACSC hospitalizations for uncomplicated hypertension increased from 4.8 per 10,000 hypertensive patients for those without hypertension-related PCP visits before diagnosis to 10.5 per 10,000 hypertensive patients for those with 5 or more hypertension-related PCP visits. The rate of ACSC hospitalizations and/or ED visits for uncomplicated hypertension increased as the number of hypertension-related PCP visits increased even after stratifying according to demographic and clinical characteristics. Conclusions: As the frequency of hypertension-related PCP visits increased, the rate of ACSC hospitalizations and/or ED visits for uncomplicated hypertension increased. This suggests that ACSC hospitalization for uncomplicated hypertension might not be a particularly good indicator for access to primary care.
UR - http://www.scopus.com/inward/record.url?scp=84919709479&partnerID=8YFLogxK
U2 - 10.1016/j.cjca.2014.09.035
DO - 10.1016/j.cjca.2014.09.035
M3 - Article
C2 - 25475466
AN - SCOPUS:84919709479
SN - 0828-282X
VL - 30
SP - 1640
EP - 1648
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
IS - 12
ER -