The CVRN Hypertension Dataset consist of adult patients with hypertension. Patients were included in the dataset if they met one of the following categories of hypertension between January 1, 2000 and December 31, 2009:
- Recognized hypertension defined as:
- Two diagnoses of hypertension at a non-urgent ambulatory visit on separate dates, or
- One diagnosis of hypertension and at least one dispensing of an anti-hypertensive medication, or
- One diagnosis of hypertension and at least one elevated outpatient blood pressure at a non-urgent ambulatory visit.
- Unrecognized hypertension defined as:
- Two or more consecutive elevated blood pressures at non-urgent ambulatory visits on separate dates without an accompanying hypertension diagnosis or hypertension treatment.
The dataset is comprised of data across three participating sites: Kaiser Permanente Northern California (KPNC), Kaiser Permanente Colorado (KPCO), and HealthPartners Institute for Education and Research (HPIER).
The CVRN hypertension cohort consists of nearly 1.75 million patients aged 18 years or older across the participating sites. KPNC enrolled 1,286,274 members, KPCO 211,194 members, HPIER 248, 373 members.
Table 1. CVRN Hypertension Dataset Member Counts by Site
Kaiser Permanente Northern California
Kaiser Permanente Colorado
Of the 1,286,274 KPNC members, 51% qualified for entry with a hypertension diagnosis and hypertension medication. 43% qualified for entry with two consecutive elevated blood pressure measurements. 43% qualified for entry with two consecutive elevated blood pressures. 34% qualified for entry with a hypertension diagnosis and elevated blood pressure measurement. And 3% qualified for entry with two hypertension diagnosis.
Of the 211,194 KPCO members 42% qualified for entry with a hypertension diagnosis and hypertension medication. 50% qualified for entry with two consecutive elevated blood pressure measurements. 32% qualified for entry with a hypertension diagnosis and an elevated blood pressure measurement. 6% qualified for entry with two hypertension diagnoses.
Of the 248,373 HPIER members 63% qualified for entry with a hypertension diagnosis and hypertension medication. 19% qualified for entry with two consecutive elevated blood pressure measurements. 12% qualified with a hypertension diagnosis and an elevated blood pressure measurement. 15% qualified with two hypertension diagnoses.
Figure 1. Proportion of CVRN Hypertension Dataset Members with at Least One Blood Pressure in Electronic Medical Record, by Year and Site
(HPIER-Filtered: a subset of the population that visited an HPIER-owned clinic during the year of their superset entry)
Figure 2. Distribution of Entry Criteria by Site in CVRN Hypertension Dataset
Figure 2 Legend
DXRX= HTN Diagnosis + Medication
2EBP= Two consecutive Elevated Blood Pressures
DXEBP= HTN Diagnosis + EBP
2DX= Two HTN Diagnoses
Figure 3. Distribution of Age and Gender by Site in CVRN Hypertension Dataset
All member data was extracted using the Virtual Data Warehouse (VDW). The VDW is a standardized resource comprised of: (1) computerized datasets stored behind separate security firewalls, including variables with identical names, formats, and specifications; (2) informatics tools that facilitate storage, retrieval, processing, and managing the datasets; and (3) detailed data documentation. All data are linked by a unique identifier so that data elements can be rolled up to the individual person-level. The three sites included in the CVRN Hypertension Dataset have different business models that are important when planning analyses or cohort selections.
KPNC has nearly 100% traditional group-model membership, meaning nearly all of their members have a complete spectrum of data during their enrollment. KPNC owns its own hospitals and clinics so that most data sources are from internal data systems rather than outside claims.
KPCO owns the outpatient clinics where members receive most of their care, but it does not own hospitals. Therefore, inpatient data, hospitals ambulatory, and certain types of specialty visits with outside providers come in through claims systems.
HPIER has an open network model, resulting in a mix of clinic usage patterns, and does not have specific plan types to identify these patterns. Their model has about 1/3 members with electronic medical record data, and members can come in and out of the owned clinic system at any time.
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