Pilot study of a new model for managing hypertension in an uninsured population.

Abstract

For millions of uninsured Americans who have hypertension, quality medical care is too expensive to access with any regularity. The Community-based Chronic Disease Management (CCDM) Clinic was created to deliver clinical care for medically uninsured patients in a setting of low resources and high need. CCDM's model melds nurse-led teams with the chronic disease model and uses evidence-based clinical decision protocols. This new model of care differs from traditional models. CCDM conducted a nonrandomized prospective trial of the effectiveness of this new model of care. The intervention included free education, medications, and laboratory investigations. For hypertensives treated for 6 months and 1 year, national benchmark goals were reached for 45% (50/110, P < .00005) and 56% (43/77, P < .00005) of patients, respectively, compared with 18% and 22% being at goal at initial presentation. The CCDM model may have implications for health service delivery in insured populations as well. Further study is warranted.