Audit of Hypertension Care in a Primary Health Care Center in Abha City, Saudi Arabia
/ 0
- Details
- Category: Vol. 80, December 2012
- Hits: 1142
Audit of Hypertension Care in a Primary Health Care Center in Abha City, Saudi Arabia,MOHAMMAD M. MOGBEL and ABDULLAH A. KHAWAJI
Abstract
Objectives: To evaluate structure, process and outcome of hypertension care in a primary health care center (PHCC).
Methodology: This study was based on the information provided in the files of all hypertensive patients (n=218), who attended Al-Manhal PHCC during the period from 1/1/2011 to 31/12/2011. The structure of hypertension care was assessed by two checklists. The process of hypertension care was assessed by two checklists. The outcome indicators were undertaken according to the Quality Assurance in Primary Health Care Manual. The last blood pressure reading during the year 2011 was taken. The patient was labeled as “controlled” if his blood pressure was <140/90mmHg or “uncontrolled” if it was equal to or more than 140/90mmHg.
Results: The main risk factors for hypertension were diabetes (42.7%) and obesity (78.5%). Check-list of the structure resources score was 32 (out of 47), while the mean score for process evaluation for hypertensive patients was 34 (out of 50). The annual general physical examination was almost completely ignored by physicians, referral to specialists was done for 11.5%, while health education was offered for almost all patients. Most routine investigations were requested to be performed at the secondary health care level, with high proportion of no feedback. Control of systolic blood pressure reached 37.2% while that for diastolic blood pressure was 47.2%. Incidence of systemic complications was generally low.
Conclusions: Main risk factors for hypertension include diabetes and obesity. Primary health care physicians are not trained on proper registration and documentation of medical records. The primary health care centre lacks a standardized protocol for management of hypertension. The health care team does not include a dietitian, social workers or a physician qualified to carry out fundoscopy. The primary health care process needs improvement. The general physical examination of hypertensive patients is rarely done. The design of medical records for follow-up of patients contains several problems. The success rates for control of blood pressure of hypertensive patients are low. All these negative findings should be dealt with accordingly. Moreover, audit studies should be performed at several primary health care centers caring for other chronic diseases.