Ashworth Mark, Medina Jibby, Morgan Myfanwy
King's College London, Department of General Practice and Primary Care, Division of Health and Social Care Research, London.
BMJ. 2008 Oct 28;337:a2030. doi: 10.1136/bmj.a2030.
To determine levels of blood pressure monitoring and control in primary care and to determine the effect of social deprivation on these levels.
Retrospective longitudinal survey, 2005 to 2007.
General practices in England.
Data obtained from 8515 practices (99.3% of all practices) in year 1, 8264 (98.3%) in year 2, and 8192 (97.8%) in year 3.
Blood pressure indicators and chronic disease prevalence estimates contained within the UK quality and outcomes framework; social deprivation scores for each practice, ethnicity data obtained from the 2001 national census; general practice characteristics.
In 2005, 82.3% of adults (n=52.8m) had an up to date blood pressure recording; by 2007, this proportion had risen to 88.3% (n=53.2m). Initially, there was a 1.7% gap between mean blood pressure recording levels in practices located in the least deprived fifth of communities compared with the most deprived fifth, but, three years later, this gap had narrowed to 0.2%. Achievement of target blood pressure levels in 2005 for practices located in the least deprived communities ranged from 71.0% (95% CI 70.4% to 71.6%) for diabetes to 85.1% (84.7% to 85.6%) for coronary heart disease; practices in the most deprived communities achieved 68.9% (68.4% to 69.5%) and 81.8 % (81.3% to 82.3%) respectively. Three years later, target achievement in the least deprived practices had risen to 78.6% (78.1% to 79.1%) and 89.4% (89.1% to 89.7%) respectively. Target achievement in the most deprived practices rose similarly, to 79.2% (78.8% to 79.6%) and 88.4% (88.2% to 88.7%) respectively. Similar changes were observed for the achievement of blood pressure targets in hypertension, cerebrovascular disease, and chronic kidney disease.
Since the reporting of performance indicators for primary care and the incorporation of pay for performance in 2004, blood pressure monitoring and control have improved substantially. Improvements in achievement have been accompanied by the near disappearance of the achievement gap between least and most deprived areas.
确定初级保健中血压监测和控制的水平，并确定社会剥夺对这些水平的影响。
2005年至2007年的回顾性纵向调查。
英国的全科医疗诊所。
第一年从8515家诊所（占所有诊所的99.3%）获取数据，第二年从8264家（98.3%）获取数据，第三年从8192家（97.8%）获取数据。
英国质量与结果框架中包含的血压指标和慢性病患病率估计值；每家诊所的社会剥夺分数、从2001年全国人口普查获得的种族数据；全科医疗诊所特征。
2005年，82.3%的成年人（n = 5280万）有最新的血压记录；到2007年，这一比例升至88.3%（n = 5320万）。最初，位于社区最不贫困五分之一地区的诊所与最贫困五分之一地区的诊所相比，平均血压记录水平存在1.7%的差距，但三年后，这一差距缩小至0.2%。2005年，位于最不贫困社区的诊所实现血压目标水平的比例，糖尿病为71.0%（95%可信区间70.4%至71.6%），冠心病为85.1%（84.7%至85.6%）；最贫困社区的诊所分别为68.9%（68.4%至69.5%）和81.8%（81.3%至82.3%）。三年后，最不贫困诊所的目标实现率分别升至78.6%（78.1%至79.1%）和89.4%（89.1%至89.7%）。最贫困诊所的目标实现率也有类似上升，分别升至79.2%（78.8%至79.6%）和
