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Quality of Care in Medically Complex Cases Analyzed

Patients with comorbidities found more likely to have good quality of hypertension care

TUESDAY, June 2 (HealthDay News) -- Performance measures or patient ratings of care may not suffer when physicians manage cases marked by medical complexity, according to research focusing on hypertension published online June 1 in Circulation.

Laura A. Petersen, M.D., of the Houston Veterans Affairs Medical Center, and colleagues analyzed data from more than 141,000 veterans with hypertension, who were grouped into those also having certain hypertension-concordant illnesses, such as diabetes or ischemic heart disease; hypertension-discordant conditions, such as arthritis; both types; or neither.

The researchers found that those having concordant comorbidities, discordant comorbidities, or both were more likely to have overall good quality of hypertension care (odds ratios, 1.78, 1.32, and 2.25, respectively), as assessed by whether they met the JNC 7 blood pressure guidelines. Patients with and without overall good quality of care had similar rates of reporting their quality of care to be excellent or very good, the authors note.

"Contrary to expectations, patients with greater complexity had higher odds of receiving high-quality care for hypertension," wrote the authors. "Our findings should be reassuring to those who care for the most medically complex patients and are concerned that they will be penalized by performance measures or patient ratings of their care."

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