TABLE 2. Variation in observed and predicted hypertension prevalence with increasing levels of medical billing and clinical data used, overall and across health care delivery organizations (HDOs) (n = 8.92 million) participating in application of Million Hearts Hypertension Prevalence Estimator Tool — United States, 2016.
| Prevalence | Overall total |
Range across HDOs* |
||||
|---|---|---|---|---|---|---|
| Claims | Claims or problem list | Claims with problem list and clinical criteria | Claims | Claims or problem list | Claims with problem list and clinical criteria | |
|
Comorbidity prevalence, %
| ||||||
| Obesity |
10.7 |
13.1 |
45.0 |
4.6 to 34.7 |
7.2 to 35.2 |
29.6 to 51.4 |
| Diabetes |
11.3 |
12.9 |
16.4 |
6.0 to 13.8 |
6.8 to 17.5 |
9.2 to 21.8 |
| Chronic kidney disease |
3.4 |
4.4 |
7.4 |
1.2 to 5.2 |
1.4 to 6.3 |
3.6 to 9.3 |
| Combined prevalence of the above conditions | ||||||
| 0 conditions |
79.4 |
76.2 |
48.3 |
59.6 to 86.5 |
58.2 to 84.4 |
41.5 to 63.7 |
| 1 condition |
16.3 |
18.1 |
37.5 |
11.2 to 31.5 |
12.8 to 32.5 |
27.4 to 42.4 |
| 2–3 conditions |
4.4 |
5.7 |
14.3 |
2.3 to 8.9 |
2.8 to 9.3 |
8.3 to 18.1 |
|
Hypertension prevalence
| ||||||
| Observed, % |
29.1 |
30.0 |
36.0 |
17.1 to 35.4 |
18.3 to 37.8 |
24.2 to 46.1 |
| No. (millions) |
2.60 |
2.68 |
3.21 |
0.02 to 0.05 |
0.02 to 0.06 |
0.03 to 0.07 |
| Predicted† using organization-specific comorbidity data, % (95% CI) |
33.2 (33.2–33.3) |
33.9 (33.9–34.0) |
39.5 (39.5–39.5) |
30.2 to 40.1 |
30.9 to 41.4 |
35.5 to 47.6 |
| Percentage point difference,§ (95% CI) |
4.1 (4.1–4.2) |
3.9 (3.9–4.0) |
3.5 (3.5–3.6) |
0.0 to 14.7 |
0.4 to 13.9 |
1.0 to 13.8 |
| No. of additional patients identified |
366,000 |
348,000 |
312,000 |
24 to 65,000 |
731 to 67,100 |
267 to 57,700 |
| Predicted† not using organization-specific comorbidity data,¶ % (95% CI) |
38.5 (38.5–38.6) |
38.5 (38.5–38.6) |
38.5 (38.5–38.6) |
35.4 to 46.2 |
35.4 to 46.2 |
35.4 to 46.2 |
| Percentage point difference,§ (95% CI) |
9.4 (9.4–9.5) |
8.5 (8.5–8.6) |
2.5 (2.5–2.6) |
-21.1 to 4.0 |
-19.9 to 2.8 |
-14.0 to 2.8 |
| No. of additional patients identified | 838,000 | 758,000 | 223,000 | 2,910 to 119,000 | 1,770 to 114,000 | 130 to 57,800 |
Abbreviation: CI = confidence interval.
* Range of values calculated across the 25 health care delivery organizations participating in the American Medical Group Association's national learning collaborative; 95% CIs are not provided for the predicted hypertension prevalence estimates.
† Based on Million Hearts Hypertension Prevalence Estimator Tool.
§ Compared with observed prevalence. Observed prevalence was always less than predicted prevalence.
¶ The comorbidity profile of the health care delivery organization’s patient population is estimated using National Health and Nutrition Examination Survey databased on the organization’s patient population’s age, gender, and race/ethnicity characteristics.