Follow-up in hypertension patients on no more than 1 antihypertensive medication
| Characteristic | Total, no. (%)* n = 6420 | Follow-up care, no. (%)* | p value | ||
|---|---|---|---|---|---|
| 1–7 d n = 3212 | 8–30 d n = 1986 | No. 30-d follow-up n = 1222 | |||
| Age, yr, mean (95% CI) | 75.3 (75.1–75.5) | 75.0 (74.8–75.3) | 75.66 (75.3–76.0) | 75.5 (75.0–75.9) | 0.005 |
| Age, yr, median (IQR) | 74.0 (69.0–80.0) | 74.0 (69.0–80.0) | 74.0 (69.0–81.0) | 74.0 (69.0–81.0) | 0.007 |
| Sex, female | 4286 (66.8) | 2179 (67.8) | 1318 (66.4) | 789 (64.6) | 0.11 |
| Income quintile (5 = highest) | |||||
| 1 | 1236 (19.3) | 587 (18.3) | 384 (19.3) | 265 (21.7) | 0.11 |
| 2 | 1293 (20.1) | 623 (19.4) | 416 (20.9) | 254 (20.8) | |
| 3 | 1253 (19.5) | 631 (19.6) | 388 (19.5) | 234 (19.1) | |
| 4 | 1310 (20.4) | 667 (20.8) | 401 (20.2) | 242 (19.8) | |
| 5 | 1328 (20.7) | 704 (21.9) | 397 (20.0) | 227 (18.6) | |
| Rural residence | 960 (15.0) | 358 (11.1) | 355 (17.9) | 247 (20.2) | < 0.001 |
| Institution/nursing home v. residential home | 103 (1.6) | † | 63 (3.2) | † | < 0.001 |
| Medical history | |||||
| Hypertension | 4313 (67.2) | 2177 (67.8) | 1341 (67.5) | 795 (65.1) | 0.21 |
| Heart failure | 265 (4.1) | 118 (3.7) | 96 (4.8) | 51 (4.2) | 0.12 |
| Atrial fibrillation | 678 (10.6) | 366 (11.4) | 210 (10.6) | 102 (8.3) | 0.01 |
| Acute myocardial infarction | 598 (9.3) | 302 (9.4) | 194 (9.8) | 102 (8.3) | 0.39 |
| Coronary artery disease | 466 (7.3) | 220 (6.8) | 154 (7.8) | 92 (7.5) | 0.44 |
| CABG | 56 (0.9) | 21 (0.7) | 21 (1.1) | 14 (1.1) | 0.16 |
| ICD/PPM | 38 (0.6) | 14 (0.4) | 13 (0.7) | 11 (0.9) | 0.18 |
| Stroke | 244 (3.8) | 111 (3.5) | 89 (4.5) | 44 (3.6) | 0.16 |
| Diabetes mellitus | 941 (14.7) | 491 (15.3) | 275 (13.8) | 175 (14.3) | 0.34 |
| Dementia | 353 (5.5) | 142 (4.4) | 134 (6.7) | 77 (6.3) | < 0.001 |
| COPD | 1237 (19.3) | 592 (18.4) | 417 (21.0) | 228 (18.7) | 0.06 |
| Asthma | 800 (12.5) | 428 (13.3) | 253 (12.7) | 119 (9.7) | 0.005 |
| Renal disease | 147 (2.3) | 52 (1.6) | 53 (2.7) | 42 (3.4) | < 0.001 |
| Liver disease | 23 (0.4) | † | 9 (0.5) | † | 0.69 |
| Cancer | 942 (14.7) | 487 (15.2) | 278 (14.0) | 177 (14.5) | 0.50 |
| ADG score, median (IQR) | 11.0 (7.0–14.0) | 11.0 (8.0–14.0) | 11.0 (7.0–14.0) | 10.0 (6.0–13.0) | < 0.001 |
| Specialist‡ visit in year before ED visit | 823 (12.8) | 416 (13.0) | 266 (13.4) | 141 (11.5) | 0.30 |
| Any ED visits for same diagnosis year prior | 21 (0.3) | 14 (0.4) | † | † | 0.29 |
| Any hospitalization for same diagnosis 2 years prior | 14 (0.2) | † | 6 (0.3) | † | 0.53 |
| ED visit details | |||||
| ED triage score,§ 1 or 2 | 2188 (34.1) | 1173 (36.5) | 657 (33.1) | 358 (29.3) | < 0.001 |
| Ambulance arrival | 1085 (16.9) | 526 (16.4) | 346 (17.4) | 213 (17.4) | 0.53 |
| Time of presentation | |||||
| 00:00–07:59 | 660 (10.3) | 324 (10.1) | 202 (10.2) | 134 (11.0) | 0.002 |
| 08:00–15:59 | 2792 (43.5) | 1328 (41.3) | 894 (45.0) | 570 (46.6) | |
| 16:00–23:59 | 2968 (46.2) | 1560 (48.6) | 890 (44.8) | 518 (42.4) | |
| Day of presentation, weekend | 1755 (27.3) | 927 (28.9) | 530 (26.7) | 298 (24.4) | 0.009 |
| ED physician age, median (IQR) | 43 (36–50) | 42 (36–49) | 43 (37–50) | 44 (37–51) | 0.003 |
| ED physician sex, female | 1429 (22.3) | 753 (23.4) | 424 (21.3) | 252 (20.6) | 0.07 |
| ED physician years of practice, yr | |||||
| 0–5 | 1500 (23.4) | 788 (24.5) | 427 (21.5) | 285 (23.3) | 0.004 |
| 6–10 | 1234 (19.2) | 634 (19.7) | 390 (19.6) | 210 (17.2) | |
| 11–15 | 1145 (17.8) | 579 (18.0) | 371 (18.7) | 195 (16.0) | |
| > 15 | 2541 (39.6) | 1211 (37.7) | 798 (40.2) | 532 (43.5) | |
| ED physician main specialty | |||||
| 3-year EM | 3151 (49.1) | 1646 (51.2) | 932 (46.9) | 573 (46.9) | < 0.001 |
| 5-year EM | 665 (10.4) | 381 (11.9) | 178 (9.0) | 106 (8.7) | |
| FM | 2445 (38.1) | 1109 (34.5) | 826 (41.6) | 510 (41.7) | |
| Other | 159 (2.5) | 76 (2.4) | 50 (2.5) | 33 (2.7) | |
| Hospital type | |||||
| Community | 4964 (77.3) | 2527 (78.7) | 1532 (77.1) | 905 (74.1) | < 0.001 |
| Small | 460 (7.2) | 162 (5.0) | 168 (8.5) | 130 (10.6) | |
| Teaching | 996 (15.5) | 523 (16.3) | 286 (14.4) | 187 (15.3) | |
| Family physician details | |||||
| Family physician age, median (IQR) | 55.0 (47.0–62.0) | 55.0 (47.0–62.0) | 54.0 (46.0–62.0) | 55.0 (47.0–62.0) | 0.27 |
| Family physician sex, female | 1661 (25.9) | 867 (27.0) | 494 (24.9) | 300 (24.5) | 0.12 |
| Family physician years of practice, yr | |||||
| 0–5 | 285 (4.4) | 121 (3.8) | 98 (4.9) | 66 (5.4) | 0.02 |
| 6–10 | 407 (6.3) | 182 (5.7) | 143 (7.2) | 82 (6.7) | |
| 11–15 | 586 (9.1) | 284 (8.8) | 193 (9.7) | 109 (8.9) | |
| > 15 | 5142 (80.1) | 2625 (81.7) | 1552 (78.1) | 965 (79.0) | |
| Family physician remuneration model | |||||
| CCM/FHG | 2516 (39.2) | 1406 (43.8) | 717 (36.1) | 393 (32.2) | < 0.001 |
| FHN | 408 (6.4) | 137 (4.3) | 166 (8.4) | 105 (8.6) | |
| FHO/FHT | 1433 (22.3) | 638 (19.9) | 463 (23.3) | 332 (27.2) | |
| FHO/noFHT | 1463 (22.8) | 737 (22.9) | 461 (23.2) | 265 (21.7) | |
| NA/FFS | 600 (9.3) | 294 (9.2) | 179 (9.0) | 127 (10.4) | |
| Outcome | |||||
| New EBM prescription fill a year later | 3562 (55.5) | 1894 (59.0) | 1151 (58.0) | 517 (42.3) | < 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.