1069 Limited Variation In Detecting Hypertension And Diabetes Mellitus By Gps

M.M.J. Nielen - NIVEL, Utrecht, the Netherlands
F.G. Schellevis - NIVEL, Utrecht, the Netherlands
R.A. Verheij - NIVEL, Utrecht, the Netherlands
Oral Communication
Hypertension and diabetes mellitus are major risk factors for cardiovascular diseases, renal diseases and premature death. Since these diseases are rapidly increasing, high quality detection is warranted. In the Netherlands, most hypertensive and diabetic patients are detected by a General Practitioner (GP). An indicator for the quality of detection by GPs is the variation of the prevalence of these diseases between practices.
Therefore, we studied the inter-practice variation of hypertension and diabetes mellitus. Furthermore, we studied which patient, GP and practice characteristics determined the differences in prevalences of hypertension and diabetes mellitus.
Design & Methods
Data were used from the Netherlands Information Network of General Practice (LINH) in 2004. Of all 168.045 registered patients, the presence of hypertension, diabetes mellitus and all available ICPC coded symptoms and diseases, related to hypertension and diabetes, were determined. Also, the characteristics of GPs were used in the analyses. Multilevel logistic regression analyses were performed.
GP characteristics accounted for 2.3% and 2.5% of the variation in hypertension and diabetes prevalence, respectively. The most important predictors for hypertension were patient characteristics: lipid disorder (OR=3.6), obesity (OR=3.5) and diabetes mellitus (OR=2.7). Retinopathy (OR=8.9), lipid disorders (OR=3.2) and hypertension (OR=2.8) predicted the presence of diabetes mellitus. Of all GP characteristics, practice type was associated with diabetes mellitus (OR=1.3) and years of experience of the GP was associated with the presence of hypertension (OR=0.9).
The small inter-practice variation for hypertension and diabetes mellitus implies equal quality of detection. Presence of hypertension and diabetes was particularly predicted by patient characteristics.
Limited variation in detecting hypertension and diabetes mellitus by GPs