The association of continuity of care on the diagnosis of hypertension in children and adolescents

Hypertension among pediatric patients is an underdiagnosed condition. As continuity of care has been found to increase quality of pediatric care, we undertook this study to assess effect of continuity on diagnosis of pediatric hypertension. This is a retrospective analysis of 774 hypertensive patients, ages 3-18 years between June 1999 and October 2007 within the MetroHealth System in northeastern Ohio. The proportion of hypertensive patients diagnosed was assessed using coding within the electronic medical record. Continuity was assessed using the usual provider of care, defined as the number of visits to the most frequent provider divided by the total number of visits in the study period. Overall continuity did not have a statistically significant association with diagnosis (OR 0.7, CI 0.4-1.4). Our research indicates that continuity does not significantly affect diagnosis of hypertension in pediatric patients. Other approaches should be investigated to improve the significant underdiagnosis of pediatric hypertension.