Search for High Blood Pressure Suspected Patients Receiving Medical Care

Abstract

This study focuses on the search for suspected high blood pressure patients receiving medical care, particularly when encountering individuals with dangerously high blood pressure levels in hospitals. The primary objective is to confirm the diagnosis and register these patients for appropriate treatment. The study utilizes the (Flow Chart Nationwide Hospital BP) approach to create a target group and increase the rate of diagnosis for individuals with dangerously high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 110 mmHg). Furthermore, it aims to ensure that patients with high blood pressure receive proper diagnosis, registration, and consistent follow-up care. The study promotes patient awareness about their own blood pressure status, educates them on self-management, and aims to reduce complications and premature mortality associated with high blood pressure.  The target group includes 164 affiliated hospitals under the Ministry of Public Health, distributed across 76 provinces and 12 public health regions nationwide. The study evaluates results through three key performance indicators, which are presented in the Health Data Center (HDC).

The six-month study, conducted from February to July 2023 (data as of August 16, 2023), yielded significant findings. Notably, the operation to identify outpatients with SBP ≥ 180 mmHg and/or DBP ≥ 110 mmHg, who are subsequently diagnosed with hypertension, now takes place within one day (excluding emergency room cases). Comparing data between 2022 and 2023 for the same period (February to July), the results show a remarkable 22.08% increase, up from 18.62% in 2022. During the same timeframe (accumulated data from October 2022 to August 2023), the operation to identify outpatients with SBP ≥ 180 mmHg and/or DBP ≥ 110 mmHg and diagnose them with hypertension (I10 - I15) within 7 days reached 28.48%. These results represent a substantial increase from the previous year across all three key performance indicators. Several success factors contributed to these results, including strong commitment from management, policy-driven implementation, effective communication, teamwork, practical development of the Flow Chart used in practice, and clear Clinical Practice Guidelines (CPGs). Ongoing staff training and updates to CPGs have played a crucial role. Connecting patient care to the healthcare network, configuring Alert BP, improving data systems, monitoring the database, patient referrals, and continuous supervision and follow-up have all significantly contributed to this success. The study concludes with recommendations for further development, emphasizing the importance of knowledge exchange for operational guidelines and ICD-10 coding for involved parties such as doctors, nurses, and IT personnel. Clear communication with medical organizations is crucial, including ICD-10 coding for patients whose blood pressure readings have returned to normal.