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Public Health Rep. 1978 Jan-Feb; 93(1): 35–40.
PMCID: PMC1431866

Hypertension control through the design of targeted delivery models.

Abstract

If we discard some of the assumptions upon which curatively oriented medical care is based, we can design models to deliver more effective services for those with chronic diseases. Assumptions to be discarded are--that disease processes can be cured through the delivery of a "magic bullet" rather than controlled through continuous surveillance, -that the physician must be an active decision maker and thus act as gatekeeper and monitor for all disease victims, and -that care for a family of consumers must be provided together. Models for the delivery of services can then be designed to provide continuity of care for those with a specific chronic disease, and paraprofessionals can be used as gatekeepers and monitors, in combination with physicians, rather than physicians alone, to give services. Models can be targeted to reach specific high-risk groups within the population at the workplace, the school, unemployment office, or wherever groups routinely congregate for purposes other than health care. Building targeted models requires extensive knowledge of the specific geographic area and its population as well as knowledge of the natural history of the disease and its treatment. For hypertension programs, goals can be set in terms of numbers of persons whose disease is controlled and the number of new programs initiated as the result of the control efforts.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Alderman MH, Schoenbaum EE. Detection and treatment of hypertension at the work site. N Engl J Med. 1975 Jul 10;293(2):65–68. [PubMed]
  • Horoshak I. How R.N.s lower the pressure. RN. 1976 Jan;39(1):38–41. [PubMed]
  • Stimmel B. The congress and health manpower: a legislative morass. N Engl J Med. 1975 Jul 10;293(2):68–74. [PubMed]
  • Armitage P, Fox W, Rose GA, Tinker CM. The variability of measurements of casual blood pressure. II. Survey experience. Clin Sci. 1966 Apr;30(2):337–344. [PubMed]
  • Armitage P, Rose GA. The variability of measurements of casual blood pressure. I. A laboratory study. Clin Sci. 1966 Apr;30(2):325–335. [PubMed]
  • Sokolow M, Werdegar D, Kain HK, Hinman AT. Relationship between level of blood pressure measured casually and by portable recorders and severity of complications in essential hypertension. Circulation. 1966 Aug;34(2):279–298. [PubMed]
  • Verdesca AS. Hypertension screening and follow-up. J Occup Med. 1974 Jun;16(6):395–401. [PubMed]
  • Charman RC. Hypertension management program in an industrial community. JAMA. 1974 Jan 21;227(3):287–291. [PubMed]
  • Wilber JA, Barrow JG. Hypertension--a community problem. Am J Med. 1972 May;52(5):653–663. [PubMed]
  • Schoenberger JA, Stamler J, Shekelle RB, Shekelle S. Current status of hypertension control in an industrial population. JAMA. 1972 Oct 30;222(5):559–562. [PubMed]
  • Wilber JA. The problem of undetected and untreated hypertension in the community. Bull N Y Acad Med. 1973 Jun;49(6):510–520. [PubMed]
  • Caldwell JR, Cobb S, Dowling MD, de Jongh D. The dropout problem in antihypertensive treatment. A pilot study of social and emotional factors influencing a patient's ability to follow antihypertensive treatment. J Chronic Dis. 1970 Feb;22(8):579–592. [PubMed]

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