Primary care physician report and blood pressure in a low income uninsured population

The positive influence of a regular primary care physician (PCP) on health and healthcare usage has been documented. Vision of Hope Health Alliance (VOHHA) patients illustrated the importance of regular PCP care may have on diagnosis of hypertension.

METHODS: Through VOHHA, uninsured, low-income adults were provided eye care. Retrospective record review was performed on patients referred from non-medical source to determine demographic information, self reported history of HTN, diabetes mellitus (DM), PCP, PCP referral and blood pressure. BP readings were classified as 'undiagnosed HTN' based on the Seventh Report of the Joint National Commission of Prevention, Detection, Evaluation and Treatment of High Blood Pressure recommendations (≥140 mmHg or ≥90 mmHg).

Results:

No history of HTN or DM was reported by 802 of the 1240 patients examined. Of the 142 (22.5%) who were classified as undiagnosed HTN, 96 (67%) reported no current PCP. 57 (40%) reported last medical exam (lme) was <1 year and 57 (40%) were unsure of lme. Mean (SD) age was 48 (10) yrs. Health education was provided. 59 (41%) scheduled and 36 (25%) kept appointments with PCPs. There was a statistically significant relationship between report of no PCP, older age, and African American race with undiagnosed HTN (p<0.05).

Conclusions:

Although results cannot be directly compared, the importance of eye doctors' role in patient education and referral to PCPs is illustrated. Referral for patients at high risk for development of hypertension is especially important.

VOHHA is supported by the Robert Wood Johnson Foundation.