Table 3.
Physician and practice characteristics associated with clinical and technical performance on NQF0018a
| Physician/Practice Characteristic | Percent (RR, 95% CI) of physicians with >70% hypertension controlb | Percent (RR, 95% CI) who reported zero denominatorc | Percent (RR, 95% CI) who reported zero numeratord |
|---|---|---|---|
| No. years reporting with certified health IT | |||
| 1 year (Ref) | 32 | 20.5 | 8.5 |
| 2 years | 31 | 8.2 | 6.2 |
| (1.00, 0.98–1.02) | (0.75, 0.72–0.79) | (0.68, 0.62–0.74) | |
| 3 years | 36 | 14.8 | 4.3 |
| (1.09, 1.07–1.11) | (0.40, 0.36–0.44) | (0.52, 0.45–0.58) | |
| 4 years | 39 | 6.5 | 6.3 |
| (1.15, 1.12–1.18) | (0.35, 0.30–0.41) | (0.34, 0.24–0.44) | |
| Rural setting | |||
| No (Ref) | 34.7 | 12.2 | 2.8 |
| Yes | 35.8 | 7.7 | 5.2 |
| (0.94, 0.91–0.97) | (0.83, 0.76–0.91) | (0.78, 0.66–0.89) | |
| Specialty | |||
| Primary care (Ref) | 42.0 | 3.7 | 1.9 |
| Other | 27.5 | 21.7 | 8.8 |
| (0.72, 0.70–0.74) | (5.33, 5.26–5.40) | (4.61, 4.53–4.70) | |
| Obstetrics/gynecology | 41.7 | 10.2 | 6.3 |
| (1.17, 1.14–1.20) | (2.49, 2.38–2.59) | (2.75, 2.62–2.88) | |
| Neurology | 29.7 | 8.9 | 5.8 |
| (0.81, 0.76–0.85) | (2.43, 2.30–2.55) | (3.40, 3.26–3.54) | |
| Nephrology | 22.3 | 2.4 | 3.2 |
| (0.61, 0.57–0.66) | (0.58, 0.34–0.81) | (1.07, 1.19–1.56) | |
| Endocrinology | 42.2 | 2.8 | 2.5 |
| (1.10, 1.05–1.14) | (0.78, 0.51–1.04) | (1.07, 0.80–1.33) | |
| Cardiovascular surgery | 26.0 | 7.0 | 5.6 |
| (0.75, 0.70–0.80) | (1.80, 1.66–1.95) | (2.86, 2.71–3.01) | |
| Cardiology | 36.3 | 3.5 | 1.5 |
| (1.00. 0.97–1.02) | (0.91, 0.78–1.04) | (0.78, 0.59–0.93) | |
| Practice Size | |||
| Solo practice (Ref) | 39.7 | 17.0 | 6.2 |
| 2–5 clinicians | 36.3 | 18.0 | 5.9 |
| (0.94, 0.90–0.97) | (1.08, 1.02–1.14) | (1.02, 0.92–1.13) | |
| 6–10 clinicians | 36.6 | 16.0 | 6.3 |
| (0.95, 0.91–0.99) | (0.99, 0.92–1.05) | (0.91, 0.96–1.19) | |
| 11–50 clinicians | 34.4 | 14.4 | 5.3 |
| (0.89, 0.86–0.92) | (0.88, 0.82–0.94) | (0.91, 0.82–1.01) | |
| 51+ clinicians | 34.6 | 8.4 | 5.8 |
| (0.86, 0.83–0.89) | (0.54, 0.49–0.60) | (0.61, 0.52–0.70) | |
| NCQA Patient-Centered Medical Home certified | |||
| No (Ref) | 33.5 | 12.6 | 5.3 |
| Yes | 48.7 | 2.2 | 1.5 |
| (1.18, 1.16–1.21) | (0.62, 0.44–0.80) | (0.48, 0.25–0.70) | |
| Pioneer Accountable Care Organization participant | |||
| No (Ref) | 34.7 | 12.1 | 5.1 |
| Yes | 37.2 | 5.2 | 3.2 |
| (1.05, 1.01–1.08) | (0.67, 0.55–0.79) | (0.67, 0.53–0.82) |
aNQF0018 is a clinical quality measure, titled “Controlling High Blood Pressure,” which is defined as the percentage of all patients ages 18–85 years who had a diagnosis of hypertension within the first 6 months of the measurement period, or any period of time before the measurement period, whose BP was adequately controlled (<140/90 mmHg) during the measurement period. The clinical target is ≥70% hypertension control. This table provides regression results that controlled for all characteristics listed in the Supplementary File 1. bIncludes all physicians reporting to the Medicare EHR incentive program who reported on NQF0018, excluding those who reported on NQF0018 with clinically meaningless results (zero numerator or denominator). cRegression among all physicians who reported on NQF0018. dZero numerator is considered if physicians reported a non-zero denominator; regression among all physicians who reported on NQF0018.
Ref = referent group; NCQA = National Committee for Quality Assurance; RR = relative risk; CI = confidence interval.