Patterns of diagnosis and treatment of hypertension in Taiwan
Objectives: By using evidence-based practice guidelines developed in the United States, Great Britain and recommended by the World Health Organization (WHO) as references, this study attempted to analyze the pattern of ambulatory diagnosis and treatment of hypertension in Taiwan in the hope that these findings will contribute to the development of future quality guidelines for Taiwan. Methods: The study examined the outpatient claims data of the Bureau of National Health Insurance (BNHI) in the year 2000 and applied them for secondary data analysis. Based on the evidence-based guidelines, we then made a comparison in the practice pattern of hypertension in Taiwan. In addition, we also investigated the drug utilization among patients who presented with co-morbidities to see whether suboptimal treatment was in anyway linked to the development of co-morbid conditions. Results: The utilization rates of the hypertensive ambulatory care took place at a higher frequency in medical centers and clinics that offered primary care than in the regional and district hospitals. Eighty percent of the hypertensive patients sought their care from the same hospital, and the average number of visits was 6.71 per annum. Compared with the evidence-based guidelines, the yearly utilization rates were lower, but the frequency of inappropriate drug prescriptions was significantly higher in Taiwan. Conclusion: The pattern of diagnosis or drug use in hypertensive patients in Taiwan was significantly different from the evidence-based guidelines developed in the United States, Great Britain and recommended by the WHO. We urge that physicians practice according to the established, evidence-based guidelines to treat ambulatory hypertensive patients in order to assure the quality of care. We also encourage the BNHI to monitor the adherence to the guidelines on an ongoing basis.
Li, HW; Yeh, LL; Huang, AT
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