Quality Evaluation for the Diagnosis and Management of Hypertensives by Pubilc Health Doctors

Song, Yun-Mi; Kim, Yoon; Cho, Hong-Jun; Jeong, Hoi-Suk; Kim, Yong-Ik

Journal of Korean Society Quality Assurance Health Care 1996;3(1): 126.
Published online November 30, 1996.

공중보건의의 고혈압 진단 및 치료과정 평가

송윤미¹, 김윤², 조홍준³, 정희숙⁴, 김용익²

¹삼성의료원 가정의학과
²서울대학교 의과대학 의료관리학교실
³울산대학교 의과대학 가정의학과
⁴대한공중보건의사협의회

Quality Evaluation for the Diagnosis and Management of Hypertensives by Pubilc Health Doctors

Yun-Mi Song¹, Yoon Kim², Hong-Jun Cho³, Hoi-Suk Jeong⁴, Yong-Ik Kim²

¹Department of Family Medicine, Samsung Medical Center
²Department of Health Policy and Management, Medical College, Seoul National University
³Department of Family Medicine, Medical College, Ulsan University
⁴Korea Association of Public Health Doctors

Abstract

Background
Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them.
Methods
Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension.
Results
Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05).
Conclusion
These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

Key words Hypertension;Quality Assessment;Clinical Guidelines;Public Health Doctor;