PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jroyalcgpracBJGP at RCGPBJGP at PubMed CentralJ R Coll Gen Pract at PubMed CentralRCGP homepage
 
J R Coll Gen Pract. 1986 January; 36(282): 17–18.
PMCID: PMC1960363

Use of management-by-objective for the case finding and treatment of hypertension

Abstract

A management-by-objective approach was used by the health care administration of the Kupat Holim Sick Fund to improve the detection and quality of treatment of hypertension in 20 family practices in Ashdod, Israel. The number of hypertensive patients in each practice was estimated from the age—sex register and this was compared with the actual number. The combined prevalence in the 20 practices was only 20.8% of the expected prevalence, and of those treated the blood pressure of 29.6% was not under control (diastolic pressure 95 mmHg or over). The practice teams committed themselves to improving the detection of hypertension by active case finding. Once every six months for three years the health care consultant reviewed the results of detection and treatment with each team. After three years the number of hypertensive patients had increased from 977 patients (20.8% of expected prevalence) to 2914 patients (62.1%) — a three-fold increase. The percentage of treated patients whose blood pressure was not under control (diastolic pressure 95 mmHg or over) did not change substantially (from 29.6% to 27.9%). A management-by-objective approach, when accompanied by regular feedback, appears to motivate primary care teams to improve the detection of hypertension in their patients.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (523K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.
 
 

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Crawford LE, Ritchie FL, Herriott BA. Replanning Sydney hospital. 3. An experiment in management. Med J Aust. 1971 Dec 18;2(25):1291–1301. [PubMed]
  • Silverberg DS, Baltuch L, Hermoni Y, Eyal P. Control of hypertension in family practice by the doctor-nurse team. J R Coll Gen Pract. 1982 Mar;32(236):184–186. [PMC free article] [PubMed]
  • Silverberg DS, Baltuch L, Hermoni Y, Eyal P, Viskoper R, Paran E. The role of the doctor-nurse team in control of hypertension in family practice in Israel. Isr J Med Sci. 1983 Aug;19(8):752–755. [PubMed]
  • Kark SL, Gofin J, Abramson JH, Makler A, Mainemer N, Kark E, Epstein LM, Hopp C. Prevalence of selected health characteristics of men. A community health survey in Jerusalem. Isr J Med Sci. 1979 Sep;15(9):732–741. [PubMed]
  • Gofin J, Kark E, Mainemer N, Kark SL, Abramson JH, Hopp C, Epstein LM. Prevalence of selected health characteristics of women and comparisons with men. A community health survey in Jerusalem. Isr J Med Sci. 1981 Feb-Mar;17(2-3):145–159. [PubMed]
  • Hart JT. Semicontinuous screening of a whole community for hypertension. Lancet. 1970 Aug 1;2(7666):223–226. [PubMed]
  • Barber JH, Beevers DG, Fife R, Hawthorne VM, McKenzie HM, Sinclair RG, Simpson RJ, Stewart GM, Williams DI. Blood-pressure screening and supervision in general practice. Br Med J. 1979 Mar 31;1(6167):843–846. [PMC free article] [PubMed]
  • Rudnick KV, Sackett DL, Hirst S, Holmes C. Hypertension in a family practice. Can Med Assoc J. 1977 Sep 3;117(5):492–497. [PMC free article] [PubMed]
  • Silverberg DS, Rosenfeld JB, Agmon J, Regev O, Ron A. Evaluation of hypertension control in general practice. Isr J Med Sci. 1979 Oct;15(10):817–820. [PubMed]
  • Weitzman S. Use of epidemiology in primary care. Isr J Med Sci. 1983 Aug;19(8):739–741. [PubMed]
  • Haynes RB, Gibson ES, Taylor DW, Bernholz CD, Sackett DL. Process versus outcome in hypertension: a positive result. Circulation. 1982 Jan;65(1):28–33. [PubMed]
  • Logan AG, Milne BJ, Achber C, Campbell WA, Haynes RB. A comparison of community and occupationally provided antihypertensive care. J Occup Med. 1982 Nov;24(11):901–906. [PubMed]
  • Logan AG, Milne BJ, Flanagan PT, Haynes RB. Clinical effectiveness and cost-effectiveness of monitoring blood pressure of hypertensive employees at work. Hypertension. 1983 Nov-Dec;5(6):828–836. [PubMed]
  • Muir A, Howe-Davies SA, Turner RC. General practice care of non-insulin-dependent diabetes with fasting blood glucose measurements. Am J Med. 1982 Nov;73(5):637–640. [PubMed]

Articles from The Journal of the Royal College of General Practitioners are provided here courtesy of Royal College of General Practitioners