Kaiser Permanente San Diego Family Medicine Residency Program, Kaiser Permanente Southern California, San Diego, CA.
Southern California Permanente Medical Group, Research and Evaluation, Pasadena, CA.
Perm J. 2021 Aug 6;25:20.304. doi: 10.7812/TPP/20.304.
Given the increasing impact of the healthcare cost of hypertension on the economy, understanding the control of high blood pressure is warranted, particularly as it pertains to racial/ethnic disparities in hypertension control.
To understand the relationship between hypertension control and racial/ethnic concordance, we investigated whether the racial/ethnic concordance between a patient's race/ethnicity and that of the individual's provider is a predictor of high blood pressure control.
Data was collected for 612,524 patients from Kaiser Permanente Southern California who were at least 18 year old and received a diagnosis of hypertension between January 1, 2016 and December 31, 2019. A multiple regression analysis was carried out to assess the correlation between hypertension control and patient-provider concordance.
The independent variables proxying for patient-provider relationship are positive and statistically significant at the 5% level. Out of the 3 types of concordance, language has the highest standardized estimate, followed by gender and race.
We found correlations between racial/ethnic patient-provider concordance and hypertension control. Consistent with previous studies, we found that Asian patients experience more time in hypertension control. By contrast, Black and Hispanic patients have less time in hypertension control. Having the same primary care provider for a longer span of time is also positively correlated with length of hypertension control.
Correlation between racial/ethnic concordance, length of time under the primary provider's care, and length of time spent in hypertension control suggests that the patient-provider relationship remains a critical component of health outcomes.
鉴于高血压的医疗成本对经济的影响越来越大,了解高血压的控制情况是有必要的,特别是在高血压控制方面存在种族/民族差异的情况下。
为了了解高血压控制与种族/民族一致性之间的关系,我们调查了患者的种族/民族与提供者的种族/民族之间的种族/民族一致性是否是高血压控制的预测因素。
从 Kaiser Permanente Southern California 收集了 612,524 名至少 18 岁且在 2016 年 1 月 1 日至 2019 年 12 月 31 日期间被诊断患有高血压的患者的数据。进行了多元回归分析,以评估高血压控制与患者-提供者一致性之间的相关性。
代表患者-提供者关系的自变量在 5%的水平上呈正相关且具有统计学意义。在 3 种一致性类型中,语言的标准化估计值最高,其次是性别和种族。
我们发现了种族/民族患者-提供者一致性与高血压控制之间的相关性。与先前的研究一致,我们发现亚洲患者在高血压控制方面的时间更长。相比之下,黑人和西班牙裔患者的高血压控制时间更短。与主要护理提供者保持更长时间的关系也与高血压控制时间的长短呈正相关。
种族/民族一致性、在主要提供者护理下的时间长短以及高血压控制时间长短之间的相关性表明,患者-提供者关系仍然是健康结果的关键组成部分。