Abstract 150: Disparities in Blood Pressure Screening in Adults: An Analysis of NAMCS-NHAMCS Data

Abstract

BACKGROUND: Blood pressure (BP) screening in adults has been identified by the US Preventive Services Task Force as a Grade A recommendation. OBJECTIVE: To compare BP screening rates in adult patients among payer sources and provider types in two national probability samples of outpatient office visits. DESIGN/METHODS: An analysis of visit data for all patients 18 years and older in the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey-Outpatient Department (OPD) during the years 2005-2009 was performed. Data on 279,510 patient visits were analyzed, including adults seen in ambulatory or office-based settings (NAMCS, N=147,675) and hospital outpatient departments (OPD, N=131,835). BP screening rates were compared based on provider type (Family Practice, Internal Medicine, Obstetrics-Gynecology, and Cardiovascular Specialist) and payer source (Private Insurance, Medicare, Medicaid, and Self Pay). Results: Overall, BP screening rates were higher in the OPD sample (65.70% vs, 55.83%, p < .001), despite a higher mean age and higher proportion of privately insured or Medicare patients in the NAMCS sample. The odds ratio for BP screening was 1.538 for insured patients compared to self-pay in the NAMCS sample (95% CI: 1.473-1.606); however, the disparity was not observed in the OPD data. Cardiovascular specialists demonstrated the most adherence to BP screening, regardless of payer source. Overall BP screening rates are shown in Table 1. Conclusions: Analysis of two national probability samples reflected marked disparity in BP screening in adult patients based on payer source and provider type.