NIHR Collaboration for Leadership in Applied Health Research and Care for Leicestershire, Northamptonshire and Rutland, Department of Health Sciences, University of Leicester, Leicester.
Br J Gen Pract. 2013 May;63(610):e339-44. doi: 10.3399/bjgp13X667204.
Fewer patients are recorded by practices as having hypertension than are identified in systematic population surveys. However, as more patients are recorded on practice hypertension registers, mortality from coronary heart disease and stroke declines.
To determine whether the number of GPs per 1000 practice population is associated with the number of patients recorded by practices as having hypertension, and whether patients' reports of being able to get an appointment with a GP are associated with the number of GPs and the number of patients recorded as having hypertension.
Cross-sectional study of available data for all general practices in England for 2008 to 2009.
A model was developed to describe the hypothesised relationships between population (deprivation, ethnicity, age, poor health) and practice characteristics (list size, number of GPs per 1000 patients, management of hypertension) and the number of patients with hypertension and patient-reported ability to get an appointment fairly quickly. Two regression analyses were undertaken.
Practices recorded only 13.3% of patients as having hypertension. Deprivation, age, poor health, white ethnicity, hypertension management, and the number of GPs per 1000 patients predicted the number of patients recorded with hypertension. Being able to get an appointment fairly quickly was associated with the number of patients recorded with hypertension, age, deprivation, practice list size, and the number of GPs per 1000 patients.
In order to improve detection of hypertension as part of a strategy to lower mortality from coronary heart disease, the capacity of practices to detect hypertension while maintaining access needs to be improved. Increasing the supply of GPs may be necessary, as well as improvements in efficiency.
与系统人群调查中识别出的高血压患者相比，诊所记录的高血压患者人数较少。然而，随着更多的患者被记录在诊所的高血压登记簿上，冠心病和中风的死亡率下降。
确定每 1000 名患者中有多少名全科医生与诊所记录的高血压患者数量相关，以及患者能否预约全科医生的报告与全科医生数量和记录的高血压患者数量是否相关。
对 2008 年至 2009 年英格兰所有全科医生的现有数据进行横断面研究。
开发了一个模型来描述人口（贫困、种族、年龄、健康状况不佳）和实践特征（清单大小、每 1000 名患者中的全科医生数量、高血压管理）与高血压患者数量和患者报告的能够快速获得预约的能力之间的假设关系。进行了两项回归分析。
诊所仅记录了 13.3%的高血压患者。贫困、年龄、健康状况不佳、白种人、高血压管理和每 1000 名患者中的全科医生数量预测了记录的高血压患者数量。能够快速获得预约与记录的高血压患者数量、年龄、贫困、实践清单大小和每 1000 名患者中的全科医生数量有关。
为了提高高血压的检出率，作为降低冠心病死亡率策略的一部分，需要提高诊所检测高血压的能力，同时保持就诊需求。可能需要增加全科医生的供应，以及提高效率。
