Bmc Health Serv Res
-
Bmc Health Serv Res · Dec 2010
Blood pressure control and antihypertensive pharmacotherapy patterns in a hypertensive population of Eastern Central Region of Portugal.
Interventions to improve blood pressure control in hypertension have had limited success in clinical practice despite evidence of cardiovascular disease prevention in randomised controlled trials.The objectives of this study were to evaluate blood pressure control and antihypertensive pharmacotherapy patterns in a population of Eastern Central Region of Portugal, attending a hospital outpatient clinic (ambulatory setting) for routine follow-up. ⋯ Clinically important blood pressure decreases can be achieved soon after hypertension medical appointment initiation. However, many hypertensive patients prescribed with antihypertensive therapy fail to achieve blood pressure control in clinical practice, this control being worse among patients with diabetes or chronic kidney disease. As pharmacotherapy patterns seem to coincide with international guidelines, further research is needed to identify the causes of poor blood pressure control.
-
Bmc Health Serv Res · Dec 2010
Do inter-hospital comparisons of in-hospital, acute myocardial infarction case-fatality rates serve the purpose of fostering quality improvement? An evaluative study.
In-hospital case-fatality rates in patients, admitted for acute myocardial infarction (AMI-CFRs), are internationally used as a quality indicator. Attempting to encourage the hospitals to assume responsibility, the Belgian Ministry of Health decided to stimulate initiatives of quality improvement by means of a limited set of indicators, among which AMI-CFR, to be routinely analyzed. In this study we aimed, by determining the existence of inter-hospital differences in AMI-CFR, (1) to evaluate to which extent Belgian discharge records allow the assessment of quality of care in the field of AMI, and (2) to identify starting points for quality improvement. ⋯ Despite established data quality shortcomings, the magnitude of the observed differences and the nonconformities constitute leads to quality improvement. However, to measure progress, ways to improve and routinely monitor data quality should be developed.