When performance remains flat, what are some other considerations? Review of data elements of blood pressure control for primary care providers in NYC

Background/Objective:  To examine the performance on an EHR calculated patient outcome measure over a 4 year period and to review the related data elements.

Methods:  From 2010 to 2013, we examined the trend for blood pressure management for adult patients diagnosed with hypertension by 107 primary care providers in NYC. A dependent t-test was used to determine statistically significant changes for provider averages from year to year for (1) the rate of blood pressure control, (2) volume of patients, (3) number of patients diagnosed with hypertension, and (4) number of patients with hypertension with their blood pressure under control (under 140/90 mmHg).

Results: Provider average rates of blood pressure control changed minimally and were not statistically significant (2010, 67.7%; 2011, 67.6%; 2012, 67.3%; 2013, 68.9%). The increase in average volume of adult patients changed significantly from 2010 (961) to 2011 (1140) at p < 0.05, and continued to increase from 2012(1215) to 2013 (1267). The average number of patients with hypertension also increased (2010, 311; 2011, 369; 2012, 396; 2013, 414), as well as the number with blood pressure under control (2010, 213; 2011, 257; 2012, 279; 2013, 291).

Conclusion:  Despite non-significant minimal gains for the rate of blood pressure control, patient volume continues to increase, as does the number of patients diagnosed with hypertension. Providers continue to maintain control of blood pressure with their hypertensive patients irrespective of the documented number of patients diagnosed with hypertension.