1. Population Care Management and Team-Based Approach to Reduce Racial Disparities among African Americans/Blacks with Hypertension.
- Author
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Bartolome, Rowena E., Agnes Chen, Handler, Joel, Platt, Sharon Takeda, and Gould, Bernice
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EVALUATION of medical care , *BLOOD pressure measurement , *MEDICATION therapy management , *CARDIOVASCULAR disease prevention , *HYPERTENSION , *BLACK people , *DRUGS , *HEALTH services accessibility , *HEALTH status indicators , *MEDICAL protocols , *PATIENT compliance , *POPULATION , *RACISM , *WORK design , *CONTINUING education units - Abstract
Objectives: At Kaiser Permanente, national Equitable Care Health Outcomes (ECHO) Reports with a baseline measurement of 16 Healthcare Effectiveness Data and Information Set measures stratified by race and ethnicity showed a disparity of 8.1 percentage points in blood pressure (BP) control rates between African- American/black (black) and white members. The aims of this study were to describe a population care management team-based approach to improve BP control for large populations and to explain how a culturally tailored, patient-centered approach can address this racial disparity. Methods: These strategies were implemented through: 1) physician-led educational programs on treatment intensification, medication adherence, and consistent use of clinical practice guidelines; 2) building strong care teams by defining individual roles and responsibilities in hypertension management; 3) redesign of the care delivery system to expand access; and 4) programs on culturally tailored communication tools and self-management. Results: At a physician practice level where 65% of patients with hypertension were black, BP control rates (< 140/90 mmHg) for blacks improved from 76.6% to 81.4%, and control rates for whites increased from 82.9% to 84.2%. The racial gap narrowed from 6.3% to 2.8%. As these successful practices continue to spread throughout the program, the health disparity gap in BP control has decreased by 50%, from 8.1% to 3.9%. Conclusion: A sustainable program to collect self-reported race, ethnicity, and language preference data integrated with successful population care management programs provided the foundation for addressing health disparities. Cultural tailoring of a multilevel team-based approach closed the gap for blacks with hypertension. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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