TOOLS FOR IMPROVING EFFICIENCY IN CLINICAL MANAGEMENT AND SAFETY OF HYPERTENSIVE PATIENTS. EFIGIE-HTA PROJECT
Author(s)
Hidalgo A1, Orozco-Beltrán D2, Górriz JL3, Ferrer D4, Sabaté N5, Martell N6, Muñiz O7, Galgo A8
1University of Castilla-La Mancha, Toledo, Spain, 2Cabo Huertas Health Centre, San Juan de Alicante, Spain, 3Hospital Clínico Universitario, Valencia, Spain, 4Institut Català de la Salut, Tarragona, Spain, 5Hospital Vall d´Hebron, Barcelona, Spain, 6Hospital Clínico Universitario, Madrid, Spain, 7Hospital Universitario Virgen del Rocío, Sevilla, Spain, 8Centro de Salud Espronceda, Madrid, Spain
OBJECTIVES: Hypertension, due to its high prevalence, is estimated to account for 5.6%-7.5% of the total health spending in Spain. The objective of this study is to detect areas for improvement in the management of hypertensive patients within the Spanish National Health System (SNHS), so it may help clinicians, health managers and decision-makers to get the best possible clinical results. METHODS: A web-site tool for self-diagnosis was launched in 2015, with access to primary healthcare centres to detect their hypertension-related areas for improvement. Health managers could complete an ad hoc questionnaire, and compare their answers to three different scenarios: “control” (ideal results based on literature and a committee of experts), “national” (results from participating centres) and “regional” (results from centres from the same region). Areas for self-evaluation were: information systems, diagnostic tests, organizational aspects, resource consumption and training for patients and healthcare professionals. After any intervention implemented by centres to solve an area for improvement, a before-after results comparison could be made, also in economic terms. RESULTS: A total of 31 centres participated in the pilot project at national level. Related to diagnosis, 57.1% of centres followed any Preventive Care Program, 45.7% hadn´t easy access to ambulatory monitoring for diagnosis and management of hypertension and 42.9% of clinicians didn’t ask patients about substances that may modify blood pressure. Most of centres (82.9%) were not provided by any clinical expert in hypertension or cardiovascular risk. Related to patient training, many centres didn’t carry out health education activities (60%), nor workshops on diet (68.6%) and only 28.6% developed physical activity workshops aimed to hypertensive patients. CONCLUSIONS: The SNHS has undergone important advances in recent years. However, in terms of clinical management and prevention, there is scope for improving efficiency, which is the future challenge in primary care.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PHS80
Topic
Health Service Delivery & Process of Care
Topic Subcategory
Treatment Patterns and Guidelines
Disease
Cardiovascular Disorders