Key result
Student-run free clinics achieve hypertension control comparable to Medicaid and commercially insured patients.
Why the study?
Medical student-run free clinics are increasingly managing hypertension in the uninsured, but data on the quality of care they provide are limited.
Does care at a student-run free clinic achieve similar hypertension control compared to Medicaid or commercial insurance in patients with hypertension?
Cohort (n=17,851)
No
Does care at a student-run free clinic achieve similar hypertension control compared to Medicaid or commercial insurance in patients with hypertension?
Absolute Event Rate: 57% vs 58%
p-value: p=>0.99
Hypertension control at a student-run free clinic for uninsured patients is comparable to that achieved in Medicaid and commercially insured populations.
Comparable hypertension control observed in small uninsured cohort; leaves open whether student-run clinics achieve equivalent outcomes at scale.
Background: Hypertension is a potent risk factor for cardiovascular disease in the uninsured. Medical student-run free clinics are increasingly managing chronic conditions like hypertension, but there are limited data addressing the quality of care such clinics provide. This study evaluates hypertension outcomes at the East Harlem Health Outreach Partnership (EHHOP), a student-run clinic affiliated with Mount Sinai School of Medicine, in comparison to publicly and privately insured populations.Methods: A retrospective cohort analysis of EHHOP patients with hypertension (N=65) was performed. Results were compared to New York State Medicaid (N=10,117) and commercial insurance patients (N=7,669) with hypertension. The primary outcome measure was percent of patients controlled <140/90 mmHg. Secondary analyses in the EHHOP sample evaluated control below individual JNC 7 (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) goal, blood pressure trends, and factors associated with control.Results: At their most recent visits, 57% of EHHOP, 58% of Medicaid, and 59% of commercial insurance patients were controlled <140/90 mmHg. In the EHHOP sample, 47.7% (31/65) of patients met their individual goal, including 35.7% (10/28) of diabetics. The mean change in blood pressure at EHHOP was -12.3 mmHg systolic (95% CI 5.7-18.9; p<0.01) and -6.8 mmHg diastolic (95% CI 2.9-10.5; p<0.01) over a mean follow-up of 16.2 months.Conclusions: Though limited by small sample size, results suggest that hypertension control at EHHOP is equivalent to other care settings. Results also demonstrate that EHHOP patients with hypertension experience clinically meaningful reductions in blood pressure. The study supports student-run free clinics as a model for delivering quality healthcare to vulnerable populations.
No takes yet. Share an insight, caveat, or question.
Taylor et al. (2015) conducted a cohort in Hypertension (n=17,851). Care at a student-run free clinic vs. New York State Medicaid and commercial insurance patients was evaluated on Blood pressure controlled <140/90 mmHg at most recent visit (p=>0.99). Care at a student-run free clinic achieved a hypertension control rate of 57%, which was comparable to rates among Medicaid (58%) and commercially insured (59%) patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: