Follow-up in incident hypertension patients
| Characteristic | Total, no. (%)* n = 2088 | Follow-up care, no. (%)* | p value | ||
|---|---|---|---|---|---|
| 1–7 d n = 1007 | 8–30 d n = 631 | No. 30-d follow-up n = 450 | |||
| Age, yr, mean (95% CI) | 74.1 (73.9–74.4) | 73.8 (73.4–74.2) | 74.7 (74.1–75.2) | 74.2 (73.6–74.9) | 0.04 |
| Age, yr, median (IQR) | 73.0 (69.0–78.0) | 72.0 (68.0–78.0) | 73.0 (69.0–79.0) | 72.0 (68.0–79.0) | 0.03 |
| Sex, female | 1335 (63.9) | 671 (66.6) | 401 (63.5) | 263 (58.4) | 0.01 |
| Income quintile | |||||
| 1 (lowest) | 401 (19.2) | 181 (18.0) | 119 (18.9) | 101 (22.4) | 0.38 |
| 2 | 443 (21.2) | 203 (20.2) | 148 (23.5) | 92 (20.4) | |
| 3 | 384 (18.4) | 195 (19.4) | 112 (17.7) | 77 (17.1) | |
| 4 | 428 (20.5) | 207 (20.6) | 125 (19.8) | 96 (21.3) | |
| 5 (highest) | 432 (20.7) | 221 (21.9) | 127 (20.1) | 84 (18.7) | |
| Rural residence | 352 (16.9) | 136 (13.5) | 120 (19.0) | 96 (21.3) | < 0.001 |
| Institution or nursing home v. residential home | 30 (1.4) | † | 18 (2.9) | † | 0.001 |
| Medical history | |||||
| Heart failure | 56 (2.7) | 25 (2.5) | 23 (3.6) | 8 (1.8) | 0.15 |
| Atrial fibrillation | 160 (7.7) | 79 (7.8) | 52 (8.2) | 29 (6.4) | 0.53 |
| Acute myocardial infarction | 132 (6.3) | 66 (6.6) | 41 (6.5) | 25 (5.6) | 0.75 |
| Coronary artery disease | 90 (4.3) | 39 (3.9) | 31 (4.9) | 20 (4.4) | 0.59 |
| CABG | 15 (0.7) | † | 8 (1.3) | † | 0.11 |
| ICD/PPM | 10 (0.5) | † | † | † | 0.99 |
| Stroke | 57 (2.7) | 12 (1.2) | 26 (4.1) | 19 (4.2) | < 0.001 |
| Diabetes mellitus | 292 (14.0) | 140 (13.9) | 90 (14.3) | 62 (13.8) | 0.97 |
| Dementia | 91 (4.4) | 41 (4.1) | 29 (4.6) | 21 (4.7) | 0.82 |
| COPD | 345 (16.5) | 153 (15.2) | 116 (18.4) | 76 (16.9) | 0.23 |
| Asthma | 198 (9.5) | 103 (10.2) | 60 (9.5) | 35 (7.8) | 0.34 |
| Renal disease | 21 (1.0) | † | † | 12 (2.7) | < 0.001 |
| Liver disease | 9 (0.4) | † | † | † | 0.58 |
| Cancer | 275 (13.2) | 135 (13.4) | 84 (13.3) | 56 (12.4) | 0.88 |
| ADG score, median (IQR) | 9.0 (6.0–12.0) | 9.0 (6.0–12.0) | 9.0 (6.0–13.0) | 9.0 (5.0–12.0) | 0.06 |
| Specialist‡ visit in year before ED visit | 234 (11.2) | 107 (10.6) | 83 (13.2) | 44 (9.8) | 0.16 |
| ED visit details | |||||
| ED triage score,§ 1 or 2 | 706 (33.8) | 348 (34.6) | 223 (35.3) | 135 (30.0) | 0.15 |
| Ambulance arrival | 289 (13.8) | 122 (12.1) | 111 (17.6) | 56 (12.4) | 0.005 |
| Time of presentation | |||||
| 00:00–07:59 | 174 (8.3) | 80 (7.9) | 50 (7.9) | 44 (9.8) | 0.13 |
| 08:00–15:59 | 936 (44.8) | 429 (42.6) | 304 (48.2) | 203 (45.1) | |
| 16:00–23:59 | 978 (46.8) | 498 (49.5) | 277 (43.9) | 203 (45.1) | |
| Day of presentation, weekend | 577 (27.6) | 305 (30.3) | 156 (24.7) | 116 (25.8) | 0.03 |
| ED physician age, median (IQR) | 43.0 (36.0–50.0) | 42.0 (37.0–49.0) | 43.0 (37.0–50.0) | 43.0 (37.0–51.0) | 0.03 |
| ED physician sex, female | 467 (22.4) | 245 (24.3) | 126 (20.0) | 96 (21.3) | 0.10 |
| ED physician years of practice, yr | |||||
| 0–5 | 507 (24.3) | 265 (26.3) | 137 (21.7) | 105 (23.3) | 0.11 |
| 6–10 | 389 (18.6) | 184 (18.3) | 126 (20.0) | 79 (17.6) | |
| 11–15 | 379 (18.2) | 187 (18.6) | 122 (19.3) | 70 (15.6) | |
| > 15 | 813 (38.9) | 371 (36.8) | 246 (39.0) | 196 (43.6) | |
| ED physician main specialty | |||||
| 3-year EM | 1024 (49.0) | 508 (50.4) | 304 (48.2) | 212 (47.1) | < 0.001 |
| 5-year EM | 212 (10.2) | 125 (12.4) | 44 (7.0) | 43 (9.6) | |
| FM | 794 (38.0) | 341 (33.9) | 267 (42.3) | 186 (41.3) | |
| Other | 58 (2.8) | 33 (3.3) | 16 (2.5) | 9 (2.0) | |
| Hospital type | |||||
| Community | 1585 (75.9) | 786 (78.1) | 483 (76.5) | 316 (70.2) | < 0.001 |
| Small | 180 (8.6) | 60 (6.0) | 62 (9.8) | 58 (12.9) | |
| Teaching | 323 (15.5) | 161 (16.0) | 86 (13.6) | 76 (16.9) | |
| Family physician details | |||||
| Family physician age, median (IQR) | 55.0 (47.0–62.0) | 56.0 (47.0–63.0) | 55.0 (47.0–63.0) | 55.0 (45.0–62.0) | 0.09 |
| Family physician sex, female | 502 (24.0) | 250 (24.8) | 144 (22.8) | 108 (24.0) | 0.65 |
| Family physician years of practice, yr | |||||
| 0–5 | 95 (4.5) | 37 (3.7) | 32 (5.1) | 26 (5.8) | 0.27 |
| 6–10 | 139 (6.7) | 62 (6.2) | 39 (6.2) | 38 (8.4) | |
| 11–15 | 183 (8.8) | 94 (9.3) | 54 (8.6) | 35 (7.8) | |
| > 15 | 1671 (80.0) | 814 (80.8) | 506 (80.2) | 351 (78.0) | |
| Family physician remuneration model | |||||
| CCM/FHG | 727 (34.8) | 388 (38.5) | 212 (33.6) | 127 (28.2) | < 0.001 |
| FHN | 134 (6.4) | 41 (4.1) | 63 (10.0) | 30 (6.7) | |
| FHO/FHT | 536 (25.7) | 239 (23.7) | 153 (24.2) | 144 (32.0) | |
| FHO/noFHT | 486 (23.3) | 233 (23.1) | 157 (24.9) | 96 (21.3) | |
| NA/FFS | 205 (9.8) | 106 (10.5) | 46 (7.3) | 53 (11.8) | |
| Outcome | |||||
| New EBM prescription fill 1 year later | 1200 (57.5) | 626 (62.2) | 376 (59.6) | 198 (44.0) | < 0.001 |
Note: ADG = adjusted diagnosis group, CABG = coronary artery bypass graft, CCM = comprehensive care model, COPD = chronic obstructive pulmonary disease, EBM = evidence-based medication, ED = emergency department, FFS = traditional fee-for-service, FHG = family health group, FHN = family health network, FHO = family health organization, FHT = family health team, ICD = implantable cardiac device, IQR = interquartile range, LTC = long-term-care facility, NA = not applicable, PPM = permanent pacemaker.
↵* Unless otherwise indicated.
↵† Small cell size (≤ 5), cannot be reported for privacy reasons and agreement with Canadian Institute for Health Information.
↵‡ Specialist includes cardiologist or internist.
↵§ Score of 1 is highest acuity.