Evaluación de la calidad de la atención al paciente hipertenso en el Centro de Salud de Torreblanca, empleando la técnica del muestreo aleatorio por lotes

Abstract

Objectives To evaluate the quality of care in hypertensive patients in the Torreblanca Health center by using the method of lot quality assurance sampling (LQAS) with each patient list (quota) being constructed as a batch (unit of analysis), and to determine whether LQAS is a useful tool for the evaluation of clinical units. Material and methods Descriptive, longitudinal, retrospective study, set in The Torreblanca Health Center. The participants were patients aged more than 14 years old diagnosed with hypertension (blood pressure > 140/90 mmHg) attended in the Torreblanca Health Center. Total number of patients = 3,178. Main measurements: 1) Evaluation of cardiovascular risk (CVR). 2) Indication of lifestyle modifications. 3) Patients under treatment with thiazide diuretics and/or beta blockers (BB). 4) Recording of hypertension. 5) Control of hypertension (blood pressure ≤ 140/90 mmHg). Results Of the 12 lots analyzed, none complied with the five indicators to the preestablished standard: compliance with four indicators was found in one lot, compliance with three indicators was found in three lots, compliance with two indicators was found in seven lots, and compliance with only one indicator was found in one lot. The overall percentage of compliance with the indicators was as follows: CVR was calculated in 21% of hypertensive patients; of these, lifestyle modification was recommended in 58%, and 61% were under treatment with thiazide diuretics and/or beta blockers; blood pressure had been registered in the previous 9 months in 77.5% and was adequately controlled (≤ 140/90 mmHg) in 56% of hypertensive patients. Conclusions The quality of care in hypertensive patients in our healthcenter is good in general terms, especially treatment and follow-up. Improvements are required in the element of diagnosis evaluated (CVA determination). We believe that the technique of LQAS is an ideal tool for establishing a periodic evaluation system within the routine activities of health centers or services.