Variation in Diagnosing Hypertension and Diabetes in General Practice
Author Information
Author(s): Nielen Markus MJ, Schellevis François G, Verheij Robert A
Primary Institution: NIVEL (Netherlands Institute for Health Services Research)
Hypothesis
There should be no variance between general practices in the prevalence rates of diagnosed hypertension and diabetes mellitus after adjustment for patient characteristics.
Conclusion
There is a wide difference between general practices in the prevalence rates of diagnosed hypertension and diabetes mellitus, even after adjustment for patient and practice characteristics.
Supporting Evidence
- The prevalence of diagnosed hypertension was found to be 142.0 per 1000 persons.
- The highest prevalence of diagnosed hypertension was in women aged 75+ at 448.6 per 1000 persons.
- Obesity, lipid disorders, and diabetes mellitus were significant predictors of hypertension.
- Retinopathy, lipid disorders, and hypertension were significant predictors of diabetes mellitus.
Takeaway
This study looked at how different doctors diagnose high blood pressure and diabetes. It found that some doctors find a lot more cases than others, even when they should be looking at the same things.
Methodology
Data were analyzed from the Netherlands Information Network of General Practice using multilevel logistic regression analyses.
Potential Biases
Potential bias due to missing data on relevant risk factors and the inability to include GP-level variables.
Limitations
The study could not include all relevant risk factors for hypertension and diabetes mellitus, and some important patient characteristics were not systematically recorded.
Participant Demographics
Patients were registered with 75 GP practices in the Netherlands, with exclusions for those under 25 years old.
Statistical Information
Confidence Interval
66.3 to 181.7 per 1000 patients for hypertension; 22.2 to 65.8 per 1000 patients for diabetes mellitus.
Digital Object Identifier (DOI)
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