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Using Electronic Referrals to Address Health Disparities and Improve Blood Pressure Control
ORIGINAL RESEARCH — Volume 16 — August 22, 2019
PEER REVIEWED
The 10 CCPP Community Health Centers had a total of 155,454 patients. Those patients diagnosed with an e-Referral–eligible condition made up the MA all e-Referral–eligible cohort (n = 21,701; 1,866 received and 19,835 did not receive an e-Referral). From the MA all e-Referral eligible cohort, the MA e-Referral hypertension cohort was developed of the 3,817 patients who had a hypertension diagnosis and a blood pressure reading at or above 140/90 mmHg on at least 1 visit during the baseline year before e-Referral started at that clinical site. Of those 3,817 patients, 721 received an e-Referral and 3,096 did not. Of the 721 patients who received an e-Referral, 528 lacked clear evidence of having attended at least 1 session of the intervention, 56 were enrolled but did not complete the intervention, and 137 were enrolled and completed the intervention.
Figure 1.
Flowchart of the Massachusetts all e-Referral–eligible cohort and the Massachusetts e-Referral hypertension cohort. The flowchart depicts the progression of the patient population from the 10 Clinical Community Partnerships for Prevention (CCPP) Community Health Center sites to the Massachusetts all e-Referral–eligible cohort (n = 21,701) and the Massachusetts e-Referral hypertension cohort (n = 3,817).
Figure 2.
Multiple logistic regression modeling of the odds of receiving and completing an e-Referral by race/ethnicity and preferred language among 21,701 Massachusetts clinical patients seen from 2013 through 2017. The multiple logistic regression models examine the odds of referral and the odds of completing an intervention by race/ethnicity and preferred language. Brackets indicate 95% Wald confidence intervals. Abbreviation: NH, non-Hispanic.
| Variable | Odds Ratio (95% Confidence Interval) |
|---|---|
| Odds of electronic referral | |
| Non-Hispanic black vs non-Hispanic white | 1.4 (1.2–1.6) |
| Hispanic vs non-Hispanic white | 1.3 (1.1–1.4) |
| Other vs non-Hispanic white | 0.6 (0.5–0.8) |
| Spanish vs English | 1.1 (1.0–1.2) |
| Other vs English | 0.5 (0.4–0.6) |
| Odds of completing intervention | |
| Non-Hispanic black vs non-Hispanic white | 0.8 (0.5–1.2) |
| Hispanic vs non-Hispanic white | 0.9 (0.7–1.1) |
| Other vs non-Hispanic white | 0.4 (0.2–0.8) |
| Spanish vs English | 0.9 (0.7–1.1) |
| Other vs English | 0.3 (0.1–0.5) |
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