Bridging the Gap: Comparison of Hypertension Management Between Internal Medicine Residency and Faculty Practices

Introduction: Studies have shown significant racial and geographical disparities in the management of hypertension. Not much has been studied about differences of hypertension management in a residency practice. Aim: Our study aims to compare hypertension management between an Internal Medicine residency and faculty practice. Methods: We retrospectively collected data from office electronic medical record. We included all patients with diagnosis of hypertension(ICD10: I10), between the age 45-60 years, seen between August 1, 2015 and August 1, 2016. Our exclusion criteria were patients with age <45 years or > 60 years, diabetes mellitus, and pregnant patients. A total of 600 charts were reviewed. Eighty one patients were excluded. We collected the following variable; age, gender race, number of office visits in one year, total number of medications used, smoking status, BMI and rate of physician blood pressure checks. The resident group had 259 patients and faculty group had 260 patients. Results: There was no significant difference in blood pressure control between two practices. The age and gender distribution between the two practices was similar but there was a significant difference in racial distribution. Residents saw more African American patients as compared to faculty. There were more smokers seen in resident practice. The rate of repeat physician blood pressure checks after medical assistant was similar. The two practices were in different parts of Delaware County with a significant difference in uninsured rate. The Residency practice was in a city with uninsured rate of 16.3% compared to 2.0% for the faculty practice. Conclusion: The study showed that there is no significant difference in the hypertension management between resident and faculty practices despite significant racial, financial and insurance coverage disparities.