Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, México DF.
J Hypertens. 2013 Aug;31(8):1714-23. doi: 10.1097/HJH.0b013e3283613090.
Patients with hypertension require life-long care and should be monitored to identify whether they are receiving the appropriate healthcare and reach their expected health outcomes. Our objectives were to develop quality of healthcare indicators (QCI) and evaluate the quality of care that hypertensive patients receive in family medicine clinics at the Mexican Institute of Social Security.
We used a two-stage mixed methods approach: development of QCIs following the RAND-UCLA method; quality of care evaluation using electronic health record (EHR) data from 47 150 hypertensive patients who received care in 2009. We developed 15 QCIs, which were possible to construct using EHR data. The QCIs evaluated the process of care and health outcomes.
Most hypertensive patients were women (64%) more than 60 years old; 79% were overweight/obese and 31% had diabetes. On average, these patients attended regularly to the family doctor (≥7 visits a year); however, they received only 27% of recommended care. Among the hypertensive patients without comorbidity, 62% had achieved blood pressure (BP) control, whereas in the group of hypertensive patients with diabetes or chronic kidney disease, only 7% had achieved BP control.
EHR can become a source of information to evaluate routinely quality of care in developing countries that are beginning to modernize their health information systems.
高血压患者需要终身护理，并应进行监测，以确定他们是否接受了适当的医疗保健，并达到预期的健康结果。我们的目的是制定医疗质量指标（QCI），并评估墨西哥社会保障研究所家庭医学诊所中高血压患者的护理质量。
我们采用了两阶段混合方法：使用 RAND-UCLA 方法制定 QCI；使用 2009 年接受治疗的 47150 名高血压患者的电子健康记录（EHR）数据评估护理质量。我们制定了 15 个 QCI，这些 QCI可以使用 EHR 数据构建。这些 QCI评估了护理过程和健康结果。
大多数高血压患者为女性（64%），年龄超过 60 岁；79%超重/肥胖，31%患有糖尿病。这些患者平均定期到家庭医生处就诊（每年≥7 次）；然而，他们仅接受了 27%的推荐护理。在无合并症的高血压患者中，62%的患者血压得到了控制，而在患有糖尿病或慢性肾脏病的高血压患者中，只有 7%的患者血压得到了控制。
EHR 可以成为评估发展中国家常规护理质量的信息来源，这些国家正在开始使其卫生信息系统现代化。
