Personal Continuity of Care in a University-Based Primary Care Practice: Impact on Blood Pressure Control
Continuity of care is an important quality outcome of patient care. This study aimed to investigate the relationship between personal continuity and blood pressure (BP) control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retro...
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| Veröffentlicht in: | PloS one 2015-07, Vol.10 (7), p.e0134030-e0134030 |
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| creator | Hanafi, Nik Sherina Abdullah, Adina Lee, Ping Yein Liew, Su May Chia, Yook Chin Khoo, Ee Ming |
| description | Continuity of care is an important quality outcome of patient care. This study aimed to investigate the relationship between personal continuity and blood pressure (BP) control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retrospective review of medical records of patients with hypertension who had been followed up for at least 1 year in the Primary Care Clinic, University of Malaya Medical Centre, Malaysia. In this setting, doctors who provided care for hypertension included postgraduate family medicine trainees, non-trainee doctors and academic staff. Systematic random sampling (1:4) was used for patient selection. BP control was defined as less than 130/80 mm Hg for patients with diabetes mellitus, proteinuria and chronic kidney disease and less than 140/90 mm Hg for all other patients. Continuity of care was assessed using the usual provider continuity index (UPCI), which is the ratio of patient visits to the usual provider to the total number of visits to all providers in 1 year. A UPC index of zero denotes no continuity while an index of one reflects perfect continuity with only the usual provider. We reviewed a total of 1060 medical records. The patients' mean age was 62.0 years (SD 10.4). The majority was women (59.2%) and married (85.7%). The mean number of visits in a year was 3.85 (SD 1.36). A total of 72 doctors had provided consultations (55 postgraduate family medicine trainees, 8 non-trainee doctors and 9 academic staff). The mean UPCI was 0.43 (SD 0.34). Target BP was achieved in 42% of the patients. There was no significant relationship between BP control and personal continuity after adjustment for total number of visits. Continuity of care was not associated with BP control in our centre. Further studies are needed to explore the reasons for this. |
| doi_str_mv | 10.1371/journal.pone.0134030 |
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This study aimed to investigate the relationship between personal continuity and blood pressure (BP) control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retrospective review of medical records of patients with hypertension who had been followed up for at least 1 year in the Primary Care Clinic, University of Malaya Medical Centre, Malaysia. In this setting, doctors who provided care for hypertension included postgraduate family medicine trainees, non-trainee doctors and academic staff. Systematic random sampling (1:4) was used for patient selection. BP control was defined as less than 130/80 mm Hg for patients with diabetes mellitus, proteinuria and chronic kidney disease and less than 140/90 mm Hg for all other patients. Continuity of care was assessed using the usual provider continuity index (UPCI), which is the ratio of patient visits to the usual provider to the total number of visits to all providers in 1 year. A UPC index of zero denotes no continuity while an index of one reflects perfect continuity with only the usual provider. We reviewed a total of 1060 medical records. The patients' mean age was 62.0 years (SD 10.4). The majority was women (59.2%) and married (85.7%). The mean number of visits in a year was 3.85 (SD 1.36). A total of 72 doctors had provided consultations (55 postgraduate family medicine trainees, 8 non-trainee doctors and 9 academic staff). The mean UPCI was 0.43 (SD 0.34). Target BP was achieved in 42% of the patients. There was no significant relationship between BP control and personal continuity after adjustment for total number of visits. Continuity of care was not associated with BP control in our centre. Further studies are needed to explore the reasons for this.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0134030</identifier><identifier>PMID: 26214304</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Ambulatory care ; Blood ; Blood Pressure ; Chronic illnesses ; Clinics ; Continuity ; Continuity of care ; Diabetes ; Diabetes mellitus ; Family medicine ; Female ; Graduate studies ; Health care ; Health care facilities ; Hospitals, University ; Humans ; Hypertension ; Hypertension - epidemiology ; Hypertension - physiopathology ; Hypertension - therapy ; Malaysia - epidemiology ; Male ; Medical personnel ; Medical records ; Medicine ; Middle Aged ; Patient care ; Patient satisfaction ; Patients ; Physicians ; Physicians, Family ; Primary care ; Primary Health Care ; Proteinuria ; Public health ; Random sampling ; Sex Factors ; Universities and colleges</subject><ispartof>PloS one, 2015-07, Vol.10 (7), p.e0134030-e0134030</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Hanafi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Hanafi et al 2015 Hanafi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-e3a85680d6ed030879fa46119550c230f6fab3fb28c49cb483a774cc3914c61c3</citedby><cites>FETCH-LOGICAL-c692t-e3a85680d6ed030879fa46119550c230f6fab3fb28c49cb483a774cc3914c61c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516235/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516235/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26214304$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hanafi, Nik Sherina</creatorcontrib><creatorcontrib>Abdullah, Adina</creatorcontrib><creatorcontrib>Lee, Ping Yein</creatorcontrib><creatorcontrib>Liew, Su May</creatorcontrib><creatorcontrib>Chia, Yook Chin</creatorcontrib><creatorcontrib>Khoo, Ee Ming</creatorcontrib><title>Personal Continuity of Care in a University-Based Primary Care Practice: Impact on Blood Pressure Control</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Continuity of care is an important quality outcome of patient care. This study aimed to investigate the relationship between personal continuity and blood pressure (BP) control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retrospective review of medical records of patients with hypertension who had been followed up for at least 1 year in the Primary Care Clinic, University of Malaya Medical Centre, Malaysia. In this setting, doctors who provided care for hypertension included postgraduate family medicine trainees, non-trainee doctors and academic staff. Systematic random sampling (1:4) was used for patient selection. BP control was defined as less than 130/80 mm Hg for patients with diabetes mellitus, proteinuria and chronic kidney disease and less than 140/90 mm Hg for all other patients. Continuity of care was assessed using the usual provider continuity index (UPCI), which is the ratio of patient visits to the usual provider to the total number of visits to all providers in 1 year. A UPC index of zero denotes no continuity while an index of one reflects perfect continuity with only the usual provider. We reviewed a total of 1060 medical records. The patients' mean age was 62.0 years (SD 10.4). The majority was women (59.2%) and married (85.7%). The mean number of visits in a year was 3.85 (SD 1.36). A total of 72 doctors had provided consultations (55 postgraduate family medicine trainees, 8 non-trainee doctors and 9 academic staff). The mean UPCI was 0.43 (SD 0.34). Target BP was achieved in 42% of the patients. There was no significant relationship between BP control and personal continuity after adjustment for total number of visits. Continuity of care was not associated with BP control in our centre. Further studies are needed to explore the reasons for this.</description><subject>Adult</subject><subject>Aged</subject><subject>Ambulatory care</subject><subject>Blood</subject><subject>Blood Pressure</subject><subject>Chronic illnesses</subject><subject>Clinics</subject><subject>Continuity</subject><subject>Continuity of care</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Family medicine</subject><subject>Female</subject><subject>Graduate studies</subject><subject>Health care</subject><subject>Health care facilities</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>Hypertension - therapy</subject><subject>Malaysia - epidemiology</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Patient care</subject><subject>Patient satisfaction</subject><subject>Patients</subject><subject>Physicians</subject><subject>Physicians, Family</subject><subject>Primary care</subject><subject>Primary Health Care</subject><subject>Proteinuria</subject><subject>Public health</subject><subject>Random sampling</subject><subject>Sex Factors</subject><subject>Universities and 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Continuity of Care in a University-Based Primary Care Practice: Impact on Blood Pressure Control</title><author>Hanafi, Nik Sherina ; Abdullah, Adina ; Lee, Ping Yein ; Liew, Su May ; Chia, Yook Chin ; Khoo, Ee Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-e3a85680d6ed030879fa46119550c230f6fab3fb28c49cb483a774cc3914c61c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Ambulatory care</topic><topic>Blood</topic><topic>Blood Pressure</topic><topic>Chronic illnesses</topic><topic>Clinics</topic><topic>Continuity</topic><topic>Continuity of care</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Family medicine</topic><topic>Female</topic><topic>Graduate studies</topic><topic>Health care</topic><topic>Health care facilities</topic><topic>Hospitals, 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titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hanafi, Nik Sherina</au><au>Abdullah, Adina</au><au>Lee, Ping Yein</au><au>Liew, Su May</au><au>Chia, Yook Chin</au><au>Khoo, Ee Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Personal Continuity of Care in a University-Based Primary Care Practice: Impact on Blood Pressure Control</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-07-27</date><risdate>2015</risdate><volume>10</volume><issue>7</issue><spage>e0134030</spage><epage>e0134030</epage><pages>e0134030-e0134030</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Continuity of care is an important quality outcome of patient care. This study aimed to investigate the relationship between personal continuity and blood pressure (BP) control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retrospective review of medical records of patients with hypertension who had been followed up for at least 1 year in the Primary Care Clinic, University of Malaya Medical Centre, Malaysia. In this setting, doctors who provided care for hypertension included postgraduate family medicine trainees, non-trainee doctors and academic staff. Systematic random sampling (1:4) was used for patient selection. BP control was defined as less than 130/80 mm Hg for patients with diabetes mellitus, proteinuria and chronic kidney disease and less than 140/90 mm Hg for all other patients. Continuity of care was assessed using the usual provider continuity index (UPCI), which is the ratio of patient visits to the usual provider to the total number of visits to all providers in 1 year. A UPC index of zero denotes no continuity while an index of one reflects perfect continuity with only the usual provider. We reviewed a total of 1060 medical records. The patients' mean age was 62.0 years (SD 10.4). The majority was women (59.2%) and married (85.7%). The mean number of visits in a year was 3.85 (SD 1.36). A total of 72 doctors had provided consultations (55 postgraduate family medicine trainees, 8 non-trainee doctors and 9 academic staff). The mean UPCI was 0.43 (SD 0.34). Target BP was achieved in 42% of the patients. There was no significant relationship between BP control and personal continuity after adjustment for total number of visits. Continuity of care was not associated with BP control in our centre. Further studies are needed to explore the reasons for this.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26214304</pmid><doi>10.1371/journal.pone.0134030</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Ambulatory care Blood Blood Pressure Chronic illnesses Clinics Continuity Continuity of care Diabetes Diabetes mellitus Family medicine Female Graduate studies Health care Health care facilities Hospitals, University Humans Hypertension Hypertension - epidemiology Hypertension - physiopathology Hypertension - therapy Malaysia - epidemiology Male Medical personnel Medical records Medicine Middle Aged Patient care Patient satisfaction Patients Physicians Physicians, Family Primary care Primary Health Care Proteinuria Public health Random sampling Sex Factors Universities and colleges |
| title | Personal Continuity of Care in a University-Based Primary Care Practice: Impact on Blood Pressure Control |
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